Just as there are different degrees of pain intensity, there are varying causes of pain as well. For more information about a specific type of pain, please click the links below.
After a limb is amputated, it is not uncommon for patients to experience pain sensations called “phantom limb pain.” This pain occurs at the amputation site and can be felt in the place where the amputated limb used to be located. The quality of pain can include an aching sensation, burning, electric shock, tingling or cramping. This limb pain may be present at all times, or it may come and go. In many cases, the amputation pain gets worse in times of stress or emotional upset. Generally, the pain is most severe in the initial phase after the amputation, and gets better as time passes. Pain with amputation can also be sometimes associated with the use of prosthetics, due to pressure and overexertion.
References / Resources:
MayoClinic.com: http://www.mayoclinic.com/health/phantom-pain/DS00444
Ann Purdy- Living without limits: http://www.ted.com/talks/amy_purdy_living_beyond_limits.html
First Step: What to expect http://www.amputee-coalition.org/first_step/firststepv2_s1a07.html
American Pain Foundation: Amputation http://www.painfoundation.org/learn/pain-conditions/amputation/
Spotlight on Phantom Pain: http://pain.about.com/od/typesofchronicpain/a/phantom_pain.htm
Angina is a type of pain that occurs due to a reduced supply of blood to the heart as a result of heart disease. Angina pain is usually experienced as chest pain, but the pain can also occur in the jaw, shoulders, arms or in the back. The pain usually occurs as a consequence of arteriosclerosis, a hardening of the arteries of the heart, which leads to reduced blood flow to the heart muscle. As the oxygen delivery is reduced, lactic acid builds up in the muscles and causes pain. In stable angina, there is often pain with exercise that goes away after the person stops exercising. Unstable angina occurs more unpredictably, and it is often more severe in intensity and frequency. In some cases, unstable angina and can be considered a warning sign for an impending heart attack.
References / Resources:
What is Angina? http://www.nhlbi.nih.gov/health/health-topics/topics/angina/
Heart Disease and Angina (Chest Pain): http://www.webmd.com/heart-disease/guide/heart-disease-angina
MayoClinic.com http://www.mayoclinic.com/health/angina/DS00994
What is Angina? http://www.medicalnewstoday.com/articles/8886.php
Angina http://www.cnn.com/HEALTH/library/angina/DS00994.html
Arthritis is a condition that results in joint pain. This joint pain can occur because of deterioration of the joint due to aging, an autoimmune disease, or an infectious process. Arthritis can also occur as a result of a disease such as gout, sickle cell anemia or hemophilia. Arthritis can cause pain with movement of the joint, edema, and a diminished range of motion. In addition, arthritis can be associated with color changes of the skin, such as a pink or reddened skin color over the joint, as well as joint stiffness. Some people have a genetic predisposition to develop the condition because of a strong family history of arthritis. People are more at risk of developing arthritis if they are older, overweight, and/or if they have had a joint injury in the past.
References / Resources:
WebMD: http://arthritis.webmd.com/
CDC: http://www.cdc.gov/arthritis/
MayoClinic.com: Arthritis http://www.mayoclinic.com/health/arthritis/DS01122
The New York Times: Arthritis http://health.nytimes.com/health/guides/disease/arthritis/overview.html
NIAMS: Living with arthritis http://www.niams.nih.gov/Health_Info/Arthritis/default.asp
Back pain is a common cause of chronic pain, but many cases of back pain resolve on their own, without surgery. Back pain is one of the most frequent reasons for missed days of work in the United States. Back pain can involve an aching sensation, muscle soreness, a stabbing pain, pain that travels from the back down to the leg, electric shock sensations, or back spasms. Pain in the back can lead to a reduced ability to move the back, stand straight or walk normally.
References / Resources:
MayoClinic.com: Back pain http://www.mayoclinic.com/health/back-pain/DS00171
NINDS: Back pain http://www.ninds.nih.gov/disorders/backpain/backpain.htm
NIAMS: Back pain http://www.niams.nih.gov/Health_Info/Back_Pain/default.asp
Health.com: Low back pain http://www.health.com/health/condition-section/0,,20187882,00.html
A burn is a type of injury to tissue from heat, electrical currents, lightning or the UV radiation from sunlight. Burns can also occur with the type of radiation therapy used in cancer treatment. Burns are classified into three types: first degree, second degree and third degree. In first degree burns, the superficial layers of skin are affected, causing redness, edema, pain and discomfort. Second degree burns occur when the burn penetrates through to the second layer of skin, which is called the dermis. Second degree burns are characterized by blisters, edema and severe pain. Third degree burns are the most damaging because all of the layers of skin are involved, and the muscles and bone can be affected as well. If a person survives third degree burns, then skin grafts are usually needed and the process of transplanting skin from a donor or from another part of the body requires one or more surgeries.
References / Resources:
Medicinenet.com: http://www.medicinenet.com/burns/article.htm
MayoClinic.com: http://www.mayoclinic.com/health/burns/DS01176
ASSH: http://www.assh.org/Public/HandConditions/Pages/Burns.aspx
WHO: http://www.who.int/violence_injury_prevention/other_injury/burns/en/index.html
Medline Plus: http://www.nlm.nih.gov/medlineplus/ency/article/000030.htm
Cancer can cause pain in a variety of ways. However, not all patients with cancer experience pain. In some cases, tumor growth can invade the surrounding tissue or destroy tissue, or the tumor can cause pressure on the surrounding organs and press on nerves around the tumor. Bone pain can occur as the cancer grows and/or spreads throughout the body. In addition, some cancer pain arises because of chemicals that are released around where the cancer exists. Cancer surgeries can lead to postoperative pain, and radiation can cause pain if the radiation causes burning or ulceration of the skin. In addition, some types of chemotherapy can produce painful symptoms such as peripheral neuropathy, stomatitis (mouth swelling and sores), and abdominal cramping from diarrhea. However, there are many ways to treat cancer pain, and the ultimate goal is to ensure adequate pain control for every cancer patient.
References / Resources:
National Cancer Institute: http://www.cancer.gov/cancertopics/coping/paincontrol/page1
MayoClinic.com: http://www.mayoclinic.com/health/cancer-pain/CA00021
American Cancer Society: http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/Pain/PainDiary/index
Medicinenet.com: http://www.medicinenet.com/cancer_pain/article.htm
Cancer pain in children: http://www.childcancerpain.org/
The New York Times: Patient Voices-Childhood Cancer http://www.nytimes.com/interactive/2011/05/19/health/healthguide/childhood-cancer.html
Central pain is a type of pain that originates from a disorder of the central nervous system. The central nervous system includes the brain and the spinal cord. In response to issues such as trauma, strokes, tumors, seizures, multiple sclerosis or Parkinson’s disease, the central nervous system reorganizes and malfunctions, causing a person to become extremely sensitive to pain. People with central pain often report a burning sensation, but the pain can also include a tingling sensation, a pressure, aching, electric shocks and sudden increases in the level of pain. Central pain can be difficult to manage and control, and can be very intense and debilitating.
References / Resources:
NINDS: Central Pain http://www.ninds.nih.gov/disorders/central_pain/central_pain.htm
WebMD.com: Central Pain http://www.webmd.com/pain-management/guide/central-pain-syndrome
Introduction to Central Pain http://www.painonline.org/intro.htm
http://www.livestrong.com/article/265767-what-are-the-treatments-for-central-pain-syndrome-in-stroke-patients/
A Chiari malformation is a disorder in which the brain herniates down into the spinal canal. The primary symptom of a Chiari malformation is a headache, and the headache pain can be quite severe in some cases. Something as simple as a cough, a sneeze or a strain can bring on a headache when someone has a Chiari malformation. Pain can also occur in the neck and radiate down from the neck. Some people with a Chiari malformation have symptoms such as difficulty walking, dizziness, peripheral neuropathy, changes in vision or speech, and/or reduced fine motor skills. In more severe cases, a Chiari malformation can cause problems in the way that the vocal cords function. A Chiari malformation can be treated with surgery to decompress the brainstem and relieve the pressure on that area. However, in some cases, people still have symptoms after the surgery has been completed. In other cases, however, patients who have the surgery experience a complete remission of symptoms.
References / Resources:
NINDS: Chiari malformation http://www.ninds.nih.gov/disorders/chiari/chiari.htm
MayoClinic.com: Chiari http://www.mayoclinic.com/health/chiari-malformation/DS00839
ASAP.org: http://www.asap.org/index.php/disorders/chiari-malformation/
The Chiari Institute: http://www.chiariinstitute.com/chiari_malformation.html
AANS.org: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Chiari%20Malformation.aspx
Chronic fatigue syndrome (CFS) is a disorder in which fatigue is the most primary factor. In CFS, the fatigue is not caused by any other known disease. Although CFS is most well known for causing fatigue, it is also associated with chronic pain. Patients with CFS can experience chronic musculoskeletal pain, joint pain, sore throat pain and chronic headaches. CFS is also associated with enlarged lymph nodes, fatigue upon awakening and a significant increase in fatigue after exercise, exertion or stress.
References / Resources:
Pubmed Health: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002224/
CFIDS.org: http://www.cfids.org/about-cfids/symptoms.asp
CDC: http://www.cdc.gov/cfs/
Mayo Clinic.com: http://www.mayoclinic.com/health/chronic-fatigue-syndrome/DS00395
WebMD.com: http://www.webmd.com/chronic-fatigue-syndrome/default.htm
Crohn’s disease is a condition in which the digestive tract becomes inflamed. Crohn’s disease can cause diarrhea, blood loss and ulcers. The ulcers can penetrate deep into the tissue, anywhere along the digestive tract from the mouth to the anus. Symptoms may also include bloody stools, abdominal pain, cramps, joint pain and diminished appetite. Weight loss can also occur, due to a loss of appetite and malabsorption of nutrients. Crohn’s disease can cause significant chronic pain due to the abdominal discomfort, diarrhea, ulcers, fissures and joint pain.
References / Resources:
Pubmed Health: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001295/
NDDIC: http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/
CCFA.org: http://www.ccfa.org/info/about/crohns
MayoClinic.com: http://www.mayoclinic.com/health/crohns-disease/DS00104
WebMD.com: http://www.webmd.com/ibd-crohns-disease/crohns-disease/default.htm
The New York Times: Patient Voices-Crohn’s Disease http://www.nytimes.com/interactive/2008/08/27/health/healthguide/TE_CROHNS_CLIPS.html
Complex Regional Pain Syndrome (CRPS), otherwise known as Reflex Sympathetic Dystrophy (RSD), is a pain disorder that is characterized by nerve pain in an arm or leg. CRPS can begin in one or both extremities and spread to other parts of the body over a period of time. CRPS is mediated by the sympathetic nervous system, otherwise known as the “fight or flight” response, and is thought to be immune modulated. The pain syndrome can occur after trauma, crushing injuries, surgery, stroke, or a heart attack. However, sometimes it occurs in people who do not have any known risk factors. More women are affected by CRPS than men. The pain can include a burning sensation, a “toothache” sensation, and electric shocks. Temperature sensitivity, edema, and/or changes in skin color can also occur. The CRPS patients usually develop extreme hypersensitivity to pain and a degree of pain that is not expected to occur with the type of injury that originally occurred. Muscle spasms, muscular atrophy, joint damage, diminished range of motion, deformity and contractures can occur, as well as changes in hair and nails around the affected arm or leg. The chances of a full recovery are greater if a patient has an early diagnosis within the first six months after the onset of symptoms and receives treatment in a timely manner. Early detection and treatment offer patients the best chance for a full remission of symptoms.
References / Resources:
MayoClinic.com: http://www.mayoclinic.com/health/complex-regional-pain-syndrome/DS00265
RSDS: http://www.rsds.org/2/what_is_rsd_crps/index.html
NINDS: http://www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/detail_reflex_sympathetic_dystrophy.htm
WebMD.com: http://www.webmd.com/pain-management/guide/crps
For Grace: http://www.forgrace.org/women/in/pain/C10/
Epidermolysis Bullosa (EB) is a skin disorder in which the skin blisters very easily. In EB, the blisters form in reaction to the slightest contact, such as friction, exposure to heat, scratching or contact with tape. Because of these blisters, people with EB have to deal with significant amounts of chronic pain and discomfort. In some cases, the skin disorder becomes evident in infancy or in childhood, while other cases of EB become evident in the teen years or in adulthood. Severe cases of EB can cause pain, extensive scarring, feeding difficulties, problems swallowing and infection, and can even lead to early death. In most cases, EB is an inherited condition.
References / Resources:
Medscape.com: http://emedicine.medscape.com/article/1062939-overview
MayoClinic.com: http://www.mayoclinic.com/health/epidermolysis-bullosa/DS01015
NIAMS: http://www.niams.nih.gov/Health_Info/Epidermolysis_Bullosa/epidermolysis_bullosa_ff.asp
WebMD.com: http://www.webmd.com/skin-problems-and-treatments/epidermolysis-bullosa
MedlinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/001457.htm
Fibromyalgia is a condition in which a person experiences chronic musculoskeletal pain. Fibromyalgia pain can also have an impact on quality of sleep and emotions, as well as impacting memory, emotions and fatigue levels. One theory is that the central nervous system has an increased sensitivity to pain. Although some cases of fibromyalgia occur after a single precipitating event, such as a trauma, car accident or a surgical procedure, other people report that the disorder developed slowly over time. The pain disorder can also occur with other health problems, such as TMJ, irritable bowel syndrome, chronic headaches and/or mood disorders. More women are affected by fibromyalgia than men. Fibromyalgia is diagnosed by obtaining a complete health history and applying pressure to certain “tender points” on the body.
References / Resources:
NFA: http://www.fmaware.org/PageServerded3.html?pagename=fibromyalgia
MayoClinic.com: http://www.mayoclinic.com/health/fibromyalgia/DS00079
WebMD.com: http://www.webmd.com/fibromyalgia/default.htm
Rheumatology.org: http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/fibromyalgia.asp
Medscape: http://emedicine.medscape.com/article/329838-overview
The New York Times: Patient Voices- Fibromyalgia http://www.nytimes.com/interactive/2010/03/04/health/healthguide/TE_fibromyalgia.html
Frozen shoulder is a type of pain that occurs in a shoulder joint. Another term for frozen shoulder is “adhesive capsulitis.” The pain of frozen shoulder can be quite severe. It is more likely to occur in people with diabetes, autoimmune diseases, people who have a stroke, a recent arm fracture, injury or surgical procedure involving the arm. The first stage of frozen shoulder involves significant pain in the shoulder that occurs with movement of the shoulder joint. In some cases, the pain is most severe at night, and can be the cause of interrupted sleep. In this stage, people with frozen shoulder have a limited range of motion, and they usually go out of their way to avoid using that arm to avoid further shoulder pain. In the second stage of frozen shoulder, the pain is reduced but the shoulder joint becomes more immobile, range of motion is decreased, and joint stiffness increases. In the third stage of frozen shoulder, the joint loosens, range of motion improves, the condition of the joint improves and the level of pain is reduced.
References / Resources:
AAOS: http://orthoinfo.aaos.org/topic.cfm?topic=a00071
MayoClinic.com: http://www.mayoclinic.com/health/frozen-shoulder/DS00416
Orthopedics.about.com: http://orthopedics.about.com/cs/frozenshoulder/a/frozenshoulder.htm
Diabetes.org: http://www.diabetes.org/living-with-diabetes/complications/related-conditions/frozen-shoulder.html
WebMD.com http://www.webmd.com/a-to-z-guides/frozen-shoulder-topic-overview
Gout is a type of joint pain and inflammation that occurs when uric acid levels are too high in the body. When uric acid levels rise to an unacceptable level, pain and inflammation occurs because urate crystals appear around the joint. The pain most commonly exists in the joints, especially the joint of the big toe. Pain levels are usually highest in the first day or two and can last several days or several weeks. The joints can develop edema and redness, and they may be warm to the touch. The joints can become highly sensitive to even the slightest touch. Certain foods and alcoholic beverages can increase the risk of having gout pain. If a person has high blood pressure, high cholesterol or heart disease, the risk of gout is also higher. Some medications can lead to a higher risk of gout, and the condition seems to run in families. More men are affected by gout than women.
References / Resources:
WebMD.com: http://arthritis.webmd.com/tc/gout-topic-overview
Medicinenet.com: http://www.medicinenet.com/gout/article.htm
MayoClinic.com: http://www.mayoclinic.com/health/gout/DS00090
Emedicinehealth.com: http://www.emedicinehealth.com/gout/article_em.htm
Rheumatology.org: http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gout.asp
Hemophilia is a type of bleeding disorder, in which a person’s blood does not clot easily. As a result, people with hemophilia can have episodes where they are bleeding for a longer period of time than normal. Hemophiliacs can also have problems with bleeding internally and bleeding into their joints. Chronic pain occurs in hemophilia because of the joint damage that occurs from bleeding into the joints. Different types of hemophilia exist, and some people have more severe cases than others. Hemophiliacs tend to bruise easily, suffer from joint pain, and bleed excessively after minor cuts, dental procedures, surgeries and nosebleeds.
References / Resources:
NHLBI: http://www.nhlbi.nih.gov/health/health-topics/topics/hemophilia/
NIH: http://ghr.nlm.nih.gov/condition/hemophilia
Hemophilia.org: http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=0&contentid=1
MayoClinic.com: http://www.mayoclinic.com/health/hemophilia/DS00218
KidsHealth.org: http://kidshealth.org/parent/medical/heart/hemophilia.html
NYT Article: http://www.nytimes.com/interactive/2012/01/26/health/hemophilia-voices.html
HIV, otherwise known as the Human Immunodeficiency Virus, is the virus that causes AIDS. AIDS stands for Acquired Immunodeficiency Syndrome, and AIDS is a syndrome that occurs when the HIV virus weakens the immune system to the point where opportunistic infections and cancers are more likely to occur in the body. Many people with HIV/AIDS have issues with acute and chronic pain, and the problem of pain is more common in the later stages of the disease. Pain can occur with infections such as meningitis, tuberculosis infections in the joints or spine, abscesses or shingles infections. Muscle pain, joint pain, cysts and chronic diarrhea can also be a source of pain. In addition, cancer, lymphoma and Kaposi’s sarcoma can lead to problems with chronic and acute pain. People with HIV/AIDS have are more likely to experience avascular necrosis of the joints, and are more likely to experience peripheral neuropathy. For example, distal symmetrical sensory polyneuropathy (DSP) is a problem that occurs with people with HIV/AIDS. Peripheral neuropathy can cause a burning or “pins and needles” sensation, reduced sensation, and numbness.
References / Resources:
HIVGuidelines.org: http://www.hivguidelines.org/GuidelineDocuments/s-pain.pdf
Human Rights Watch: http://www.hrw.org/news/2011/02/15/many-hivaids-patients-suffer-pain-needlessly
TheWellProject.org: http://www.thewellproject.org/en_US/Living_Well/Health/HIV_Pain_Mgmt.jsp
Pubmed.com: http://www.ncbi.nlm.nih.gov/pubmed/12042556
Avert.org: http://www.avert.org/aids-pain.htm
Rheumatology.org: http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/HIV.asp
The New York Times: Patient Voices-HIV http://www.nytimes.com/interactive/2008/11/05/health/healthguide/TE_AIDS_CLIPS.html
Hydrocephalus is a condition that occurs when fluid builds up in the brain, increasing pressure within the head. The spinal cord and brain are surrounded by a fluid called cerebrospinal fluid, and hydrocephalus occurs when this fluid builds up in the ventricles of the brain. When this occurs, the ventricles become enlarged and the increased pressure can cause symptoms such as headache pain, nausea, vomiting and problems with maintaining balance. Other symptoms of hydrocephalus may include sleepiness, lethargy, vision problems, cognitive changes, or difficulty walking. Hydrocephalus can also lead to headache pain because of the increased pressure in the head. The condition can be present at birth, and it can also occur with spina bifida, brain trauma, meningitis, brain tumors, Chiari malformations, or strokes. In some cases, the cause of hydrocephalus is unknown.
References / Resources:
Medicinenet.com: http://www.medicinenet.com/hydrocephalus/article.htm
Hydrocephalus Association: http://www.hydroassoc.org/
NIH: http://www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm
MayoClinic.com: http://www.mayoclinic.com/health/hydrocephalus/DS00393
Hydrocephalus.org: http://www.hydrocephalus.org/facts.htm
Interstitial cystitis refers to chronic bladder and pelvic pain. The pain is characterized by a burning sensation, pressure, and an increased frequency of urination. The chronic pain from interstitial cystitis can be mild, moderate or severe, and the pain can be intermittent or constant. Some people with interstitial cystitis have symptoms that subside for a period of time, and then they experience flares of pain. Relapses can be triggered by certain things, such as stress, physical activity, menstrual cycles, sexual intercourse and being in a seated position for a prolonged period of time. More women are affected by interstitial cystitis than men.
References / Resources:
ICHelp.org: http://www.ichelp.org/page.aspx?pid=571
MayoClinic.com: http://www.mayoclinic.com/health/interstitial-cystitis/DS00497
MedicineNet.com: http://www.medicinenet.com/interstitial_cystitis/article.htm
WomensHealth.gov: http://www.womenshealth.gov/publications/our-publications/fact-sheet/interstitial-cystitis.cfm
Interstitial Cystitis: http://www.webmd.com/a-to-z-guides/interstitial-cystitis-11327
Lupus is a disease in which a person’s immune system targets the body rather than just attacking bacteria and viruses. When the immune system attacks the body, it causes inflammation that impacts each patient in different ways. In some people, the skin is primarily affected, while in others, the immune system attacks the organs of the body and/or the skin. Lupus can also impact the central nervous system and the brain. In Systemic Lupus Erythematosus, (SLE), the immune system targets the tissues and organs of the body. Discoid lupus occurs when the immune system primarily attacks the skin, causing a distinctive skin rash. In drug induced lupus, the immune system attacks the body as a result of a medication reaction, and the drug-induced SLE usually stops when the medication is discontinued. Neonatal lupus occurs when the immune system attacks organs and tissues in an infant. Among other symptoms, lupus patients can experience joint pain, stiff joints, inflammation of the joints and painful mouth sores. The characteristic symptoms of lupus are a butterfly (malar) rash, fevers, joint pain, hair loss, fatigue, and cognitive and/or mood changes.
References / Resources:
Lupus.org: http://www.lupus.org/newsite/index.html
MayoClinic.com: http://www.mayoclinic.com/health/lupus/DS00115
WebMD.com: http://lupus.webmd.com/
MedicineNet.com: http://www.medicinenet.com/systemic_lupus/article.htm
The New York Times- Patient Voices: Lupus http://www.nytimes.com//interactive/2009/07/08/health/healthguide/TE_LUPUS.html?ref=health
Migraines are known as severe headaches that may be accompanied by nausea, vomiting, and/or cool hands and feet. Sensitivity to lights, sounds and smells also may occur with migraines. As a result of the sensitivity to light and sound, people with migraines tend to prefer to lie in quiet, dark rooms. In some cases, migraines occur during or after an “aura,” which acts as a warning sign that a migraine is about to occur. An aura may include black spots in the field of vision, flashing lights, and/or numb and tingling sensations in the extremities. Nasal congestion and mood changes can also occur with the headache pain. Migraine headaches are thought to occur because the blood vessels in the brain dilate, causing pain. With migraines, the “fight or flight” response occurs as the sympathetic nervous system is activated. Some people find that their migraine pain is triggered by stress, exercise or eating certain foods.
References / Resources:
WebMD.com: http://www.webmd.com/migraines-headaches/default.htm
MedicineNet.com: http://www.medicinenet.com/migraine_headache/article.htm
MayoClinic.com: http://www.mayoclinic.com/health/migraine-headache/DS00120
The National Headache Foundation: http://www.headaches.org/education/Headache_Topic_Sheets/Migraine
The New York Times: Patient Voices- Migraines http://www.nytimes.com/interactive/2009/12/15/health/healthguide/TE_migraine.html
Multiple Sclerosis (MS) is a neurological disease in which the immune system attacks the nerves in the brain and the spinal cord. The body’s nerves have a special coating on the myelin sheath of the nerve, and when the immune system damages the myelin sheath, the nerves cannot transmit messages as they normally would. The nerve damage that occurs leads to disability in some cases. The symptoms of MS may come and go, or they can be progressive over time. In many cases, people with multiple sclerosis often feel chronic pain as a result of the nerve damage. The pain sensations may include peripheral neuropathy, with a burning or “pins and needles” sensation, aching, electric shock sensations, stabbing or tearing pains. Other symptoms may include heat sensitivity, blurred vision, muscle spasms, fatigue, numbness, weakness in a part of the body, or problems with walking.
References / Resources
National MS Society: http://www.nationalmssociety.org/about-multiple-sclerosis/index.aspx
MayoClinic.com: http://www.mayoclinic.com/health/multiple-sclerosis/DS00188
WebMD.com: http://www.webmd.com/multiple-sclerosis/default.htm
Multiple Sclerosis Foundation: http://www.msfocus.org/what-is-multiple-sclerosis.aspx
The New York Times: Patient Voices- Multiple Sclerosis http://www.nytimes.com/interactive/2008/12/03/health/healthguide/TE_MULTIPLESCLEROSIS.html
Spinal cord injuries are widely known to cause paralysis, numbness and disability in many cases, but they are also sometimes associated with chronic and acute pain. Approximately thirty percent of those with spinal cord injuries deal with significant pain. Acute pain arises from the trauma that caused the spinal cord injury, as well as any surgery that was done after the trauma occurred. Chronic pain can occur from overuse of muscles of the upper body, as well as any issues with the bowel and/or bladder. Central pain is a type of pain that occurs in some people with spinal cord injuries, when the central nervous system reorganizes and nerve pain and hypersensitivity to pain occurs. A type of pain called “root pain” can occur around the location of the spinal cord injury. Segmental pain can also occur around the area where the spinal cord injury occurred, and it usually involves hypersensitivity to pain. Nerve root entrapment also occurs around the location of the original spinal cord injury, where the paralysis begins. Nerve root entrapment develops when bone or disks compress a nerve root, and it can cause hypersensitivity to pain and a burning sensation. In addition, people with spinal cord injuries can have pain if their spinal cord has a syrinx, which is a type of fluid-filled cyst in the spinal cord. In some cases, the syrinx can grow in size and expand along the spinal cord. The syrinx can cause pain as it causes pressure on the spinal cord. People with spinal cord injuries can also experience musculoskeletal pain as a result of secondary overuse and muscle spasms.
References / Resources:
Spinal Cord Injury Information Network: http://www.spinalcord.uab.edu/show.asp?durki=41119
NIH: http://www.ninds.nih.gov/disorders/sci/detail_sci.htm
CNI Review: http://www.thecni.org/reviews/09-1-p20-balazy.htm
WebMD: http://www.webmd.com/pain-management/pain-management-spinal-cord-injury-medref
The New York Times: Patient Voices- Spinal Cord Injuries http://www.nytimes.com/interactive/2009/03/25/health/healthguide/TE_SPINAL_CORD_INJURY.html?ref=health
Peripheral neuropathy is a condition in which the hands and feet become numb and/or painful. The pain in peripheral neuropathy can be a burning sensation, a tingling sensation, or both. The nerve pain is a result of damage to the peripheral nerves. This nerve damage can be caused by diabetes, vitamin B12 deficiency, trauma, or infections. Peripheral neuropathy pain can also occur in some people who are undergoing chemotherapy to treat cancer, and some people who are taking certain medications. In addition, peripheral neuropathy can occur after taking excessive doses of a B vitamin called pyridoxine, otherwise known as vitamin B6. Peripheral neuropathy can cause a burning and/or “pins and needles” sensation, reduced sensation, numbness, difficulty walking, weakness or paralysis.
References / Resources:
NIH: http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm
MedlinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/000593.htm
WebMD: http://www.webmd.com/brain/understanding-peripheral-neuropathy-basics
The Neuropathy Association: http://www.neuropathy.org/site/PageServer?pagename=About_Facts
The Mayo Clinic: http://www.mayoclinic.com/health/peripheral-neuropathy/DS00131
After surgery, patients commonly experience acute pain. Although post operative pain cannot be totally eliminated in all cases, it can be well controlled. When surgical pain is not in good control, it can impact heart rate and blood pressure, respiratory effort, and nausea and vomiting. Pain is very stressful to the body and results in the release of stress hormones that can weaken the immune system. Statistically, patients are more likely to have infections after surgery if their pain is not in good control, and uncontrolled pain is also correlated with longer hospital stays. Usually, the pain of surgery goes away after the body heals. In some cases, however, chronic pain can continue long after the surgery date. Chronic pain from surgery can occur because of problems such as nerve damage, inflammation, complications during or after surgery, or adhesions. Some examples of chronic pain after surgery are back pain after spinal surgery and phantom limb pain after an amputation.
References / Resources:
Emedicinehealth.com: http://www.emedicinehealth.com/pain_after_surgery/article_em.htm
My.ClevelandClinic.org: http://my.clevelandclinic.org/services/pain_management/hic_pain_control_after_surgery.aspx
MayoClinic.com: http://www.mayoclinic.com/health/pain-medications/PN00060
Encyclopedia of Surgery: http://www.surgeryencyclopedia.com/Pa-St/Post-Surgical-Pain.html#b
WebMD: http://www.webmd.com/pain-management/features/managing-pain-after-surgery
Post vasectomy pain syndrome is chronic pain that can occur after a vasectomy. Most people with vasectomies do not experience chronic pain, but for those who do, the pain can be debilitating. The genital pain can begin immediately after the vasectomy, or it can long after the vasectomy was completed. The pain can be triggered by exercise, erection, intercourse and/or ejaculation. The pain is theorized to occur from nerve trauma, nerve entrapment, cysts, granulomas, and/or an increased pressure in the vas deferens of the testicles. The pain can also originate from scar tissue that develops after the vasectomy surgery.
References / Resources:
http://www.andrologyjournal.org/cgi/content/full/24/3/293
http://www.ncbi.nlm.nih.gov/pubmed/21845426
http://www.ncbi.nlm.nih.gov/pubmed/16263006
http://www.ncbi.nlm.nih.gov/pubmed/1537032
http://malereproduction.com/vasectomy_reversal/post-vasectomy-pain-syndrome/
http://www.vasectomypain.org/home
http://www.vasectomymedical.com/vasectomy-pain.html
http://vasectomysideeffects.blogspot.com/p/my-vasectomy-story.html
The prostate is a gland located in men under the bladder. Prostatitis occurs with inflammation of the prostate, which causes painful urination. Prostatitis can also cause the urine flow to be partially obstructed. A person with prostatitis can experience hesitation with urination, or urination that occurs too slowly. Besides pain with urination, pain can also occur in the pelvis and groin area. Prostatitis can also cause symptoms that are similar to the flu. The disorder can be caused by infection with one or more types of bacteria. However, in other cases, the cause of prostatitis is unknown. Prostatitis can be acute or chronic, with symptoms ranging anywhere along the spectrum from mild to severe. Prostatitis pain can occur when bacteria from urine gets into the prostate. In cases where the cause is unknown, the prevailing theory is that the prostate becomes inflamed as a result of the immune system becoming overactive.
References / Resources:
MedicineNet.com: http://www.medicinenet.com/prostatitis/article.htm
MayoClinic.com: http://www.mayoclinic.com/health/prostatitis/DS00341
WebMD.com: http://men.webmd.com/prostatitis
Medscape Reference: http://emedicine.medscape.com/article/785418-overview
Rheumatoid arthritis (RA) is an autoimmune condition that occurs when the immune system attacks the lining of the joints in the body. This can cause significant pain, swelling and joint damage as the disease progresses. The lining of the joints is called the synovium, and as the synovium becomes inflamed, it can damage the joint’s cartilage and bone. The resulting damage can cause the joint to become deformed and lose its former ability to function normally. RA is usually characterized by stiff joints in the morning, joint pain and swelling. Fevers, fatigue, skin nodules and weight loss can also occur with rheumatoid arthritis.
References / Resources:
MedicineNet.com: http://www.medicinenet.com/rheumatoid_arthritis/article.htm
MayoClinic.com: http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020
WebMD.com http://www.webmd.com/rheumatoid-arthritis/default.htm
Emedicinehealth.com: http://www.emedicinehealth.com/rheumatoid_arthritis/article_em.htm
The New York Times: Patient Voices- Rheumatoid Arthritis http://www.nytimes.com/interactive/2009/11/19/health/healthguide/TE-rheumatoid-arthritis.html
Sciatica is a condition in which nerve pain occurs in the sciatic nerve, traveling from the lower back and down the leg. The sciatic nerve provides muscle control and sensation to the legs and the feet. Sciatic nerve pain is a side effect of an issue with the sciatic nerve, such as post-polio syndrome, compression of the sciatic nerve from a disc herniation, or a tumor in the spinal cord. The nerve pain in sciatica often resolves on its own in a few months, but sometimes develops into chronic pain. This sciatic pain can be an aching sensation, a burning sensation, or a feeling of electric shocks. The pain can be intensified by sitting in a chair for a prolonged period of time, as well as by coughing or sneezing.
References / Resources:
WebMD.com: http://www.webmd.com/back-pain/guide/sciatica-symptoms
MayoClinic.com: http://www.mayoclinic.com/health/sciatica/DS00516
AAOS: http://orthoinfo.aaos.org/topic.cfm?topic=a00351
MedlinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/000686.htm
PubMed Health: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001706/
Shingles is a blistering rash that occurs in a section of one side of the body, along a nerve pathway called a “dermatome.” It occurs as a result of a reactivation of the chicken pox virus in the dermatome. When a person first becomes infected with the chicken pox virus, usually as a child, they recover from the initial illness and the virus lies dormant in the nerve pathway. Shingles occurs on one side of the body. The shingles rash is most likely to occur in older people and those who are immune compromised, such as people with AIDS, immune deficiencies and cancer. Chronic nerve pain can develop after the shingles rash disappears. This nerve pain can be intermittent or constant, and it can be intense and debilitating in the acute and chronic phase. Post-herpetic neuralgia is a type of chronic nerve pain that can develop after the shingles rash disappears.
References / Resources:
WebMD: http://www.webmd.com/skin-problems-and-treatments/shingles/shingles-topic-overview
MayoClinic.com: http://www.mayoclinic.com/health/shingles/DS00098
CDC: http://www.cdc.gov/shingles/about/index.html
MedicineNet.com: http://www.medicinenet.com/shingles/article.htm
NIH: http://www.ninds.nih.gov/disorders/shingles/shingles.htm
Sickle cell anemia is an inherited condition characterized by a deficiency of normal red blood cells in the body. In people with sickle cell anemia, the red blood cells have a tendency to change from a round shape to a crescent “sickle” shape. The sickled red blood cells are more likely to stick together and block the flow of blood in blood vessels. Since red blood cells carry oxygen throughout the body, the sickle cells slow down or cut off the oxygen supply in the surrounding area. Sickled red blood cells have a shorter life span compared with normal red blood cells, which leads to anemia. Consequently, sickle cell anemia leaves a person without enough normal red blood cells to carry sufficient amounts of oxygen throughout the body. People with sickle cell anemia are more likely to have strokes and have problems with damage to their eyes, from retinal occlusion. One of the most significant symptoms of sickle cell anemia is acute and chronic pain. Pain can occur when the sickled blood cells cause a problem with the function of an organ in the body, or when sickled blood cells clump together in one or more blood vessels and cause a blockage. The hands and feet can become swollen and painful because of a blockage of the small blood vessels in the extremities, and joint pain can occur. A serious, life-threatening health crisis called “acute chest syndrome” occurs when the sickled red blood cells become occluded in the lungs. The symptoms of an acute chest syndrome can include chest pain, coughing, mucous production from the lungs, difficulty breathing, fevers, and/or lower oxygen levels in the blood.
References / Resources:
NHLBI: http://www.nhlbi.nih.gov/health/health-topics/topics/sca/
MayoClinic.com: http://www.mayoclinic.com/health/sickle-cell-anemia/DS00324
WebMD: http://www.webmd.com/a-to-z-guides/sickle-cell-disease-topic-overview
ASCAA: http://www.ascaa.org/What_is_Sickle_Cell_Anemia.asp
The New York Times: Patient Voices- Sickle Cell Anemia http://www.nytimes.com/interactive/2011/03/02/health/healthguide/te_sicklecell.html
Spinal stenosis occurs when the spinal canal narrows and compresses the spinal cord and/or spinal nerves surrounding the narrowed area. In many cases, spinal stenosis occurs as a result of the aging process; the risk for spinal stenosis increases as a person gets older. It can also occur because of a genetic predisposition. Some people with spinal stenosis do not have any symptoms at all. However, spinal stenosis can cause significant chronic pain and/or a loss of sensation in the arms, legs, neck or back. In severe cases of spinal stenosis, weakness can occur in the arms and legs, as well as losing control of bladder or bowel function.
References / Resources:
NIH: http://www.niams.nih.gov/Health_Info/Spinal_Stenosis/
MayoClinic.com: http://www.mayoclinic.com/health/spinal-stenosis/DS00515
WebMD.com: http://www.webmd.com/back-pain/tc/lumbar-spinal-stenosis-topic-overview
MedicineNet.com: http://www.medicinenet.com/lumbar_stenosis/article.htm
The thoracic outlet is found in the area between the collarbone and the first rib. In thoracic outlet syndrome, the thoracic outlet is compressed. Chronic pain occurs because of a reduced blood supply to the nerves and blood vessels in that area. Thoracic outlet syndrome sufferers often report neck pain, shoulder pain and other aches in that general region. In some cases, thoracic outlet syndrome causes reduced sensation in the fingers. The syndrome can be caused by trauma, repetitive movements such as typing, a fibrous band, or pregnancy. In rare instances, the syndrome occurs as a result of a tumor or an extra rib bone. However, in some people, there is no known cause.
References / Resources:
MedicineNet.com: http://www.medicinenet.com/thoracic_outlet_syndrome/article.htm
MayoClinic.com http://www.mayoclinic.com/health/thoracic-outlet-syndrome/DS00800
NIH: http://www.ninds.nih.gov/disorders/thoracic/thoracic.htm
AAOS: http://orthoinfo.aaos.org/topic.cfm?topic=a00336
Medscape Reference: http://emedicine.medscape.com/article/760477-overview
Trigeminal neuralgia involves chronic nerve pain on the face, from the trigeminal nerve. The nerve pain of trigeminal neuralgia usually involves chronic facial pain. This nerve pain can occur with activities such as opening the mouth, chewing food or talking. Although trigeminal neuralgia is usually associated with brief episodes of pain, the attacks of pain can increase in length and severity as time passes, in some cases. Even a simple act such as touching the face or smiling can trigger an episode of trigeminal neuralgia. This facial pain can be a burning sensation, an electric shock sensation, or both.
References / Resources:
MayoClinic.com: http://www.mayoclinic.com/health/trigeminal-neuralgia/DS00446
NIH: http://www.ninds.nih.gov/disorders/trigeminal_neuralgia/detail_trigeminal_neuralgia.htm
Medscape Reference: http://emedicine.medscape.com/article/794402-overview
AANS: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Trigeminal%20Neuralgia.aspx
MedicineNet.com: http://www.medicinenet.com/trigeminal_neuralgia/article.htm
Ulcerative colitis is a disorder that occurs because of inflammation of the large intestine and colon. The inner lining of the large intestine becomes inflamed, which can cause pain, loose stools and gastrointestinal bleeding. Pain can also occur from having the sensation of needing to pass stool, but being unable to do so. Weight loss can also be an issue with ulcerative colitis. Severe cases of ulcerative colitis can be life threatening. The current theory about the cause of ulcerative colitis is that it is the result of an infection with a bacteria or virus, or that it is an autoimmune disease where the immune system attacks the large intestine and colon.
References / Resources:
NDDIC: http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/
MayoClinic.com: http://www.mayoclinic.com/health/ulcerative-colitis/DS00598
MedicineNet.com: http://www.medicinenet.com/ulcerative_colitis/article.htm
WebMD.com: http://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/ulcerative-colitis-topic-overview
ASCRS: http://www.fascrs.org/patients/conditions/ulcerative_colitis/
Vulvodynia is a disorder of chronic pain around the opening of the vagina. This vaginal pain can involve a burning sensation, a deep ache, an itching, a stinging sensation, and/or throbbing. In some cases, edema and color changes are present. In other cases, there are no visible signs of the disorder other than the patient’s report of vagina pain. Current theories about the origin of the pain include infection, nerve injury and/or an allergic reaction. However, some patients with vulvodynia do not have a history or infection, trauma or allergies, and the cause of the disorder is unknown.
References / Resources:
MayoClinic.com: http://www.mayoclinic.com/health/vulvodynia/DS00159
WebMD.com: http://women.webmd.com/vulvodynia
About.com- Women’s Health http://womenshealth.about.com/cs/vulvodynia/a/vulvodyniaqapt1.htm
National Vulvodynia Association: http://www.nva.org/programs.html#
http://www.v-matters.org/