Classification of pain (Table 1.1)
 Classification of pain (Table 1.1) |
| Nociceptive—superficial somatic | Nociceptive—deep somatic | Nociceptive—visceral | Neuropathic | |
skin subcutaneous tissue mucosa of mouth, nose, sinuses, urethra, anus | bones, joints, muscles, tendons, ligaments superficial lymph nodes organ capsules and mesothelial membranes (pleura and peritoneum) | solid or hollow organs deep tumour masses deep lymph nodes | damage to nociceptive pathways | |
malignant ulcers stomatitis | bone fracture bone metastases liver capsule distension or inflammation | deep abdominal or mediastinal masses intestinal, biliary, or ureteric colic | non–tumour-related: postherpetic neuralgia, post-thoracotomy syndrome, phantom pain tumour-related: lumbosacral, brachial plexus or chest wall invasion, spinal cord compression | |
hot sharp stinging | dull aching throbbing | dull deep cramping, colicky pressure/tightness | dysaesthesia (eg pins and needles, tingling, burning, lancinating/shooting) allodynia pain in a missing body part pain in a numb area | |
very well defined | well defined | poorly defined | nerve or dermatome distribution | |
no effect | worsening pain (patient prefers to be still) | may improve pain | nerve traction provokes pain (eg sciatic stretch) | |
no | yes | yes | yes | |
yes | yes | maybe | usually no, but normal stimuli may provoke pain | |
no | may occur | nausea, vomiting, sweating, blood pressure and heart rate changes | autonomic instability: warmth, sweating, pallor, cold, cyanosis |
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