Pain is a feeling in the body that is described as physical suffering or discomfort. This suffering and discomfort is usually either caused by illness or by an injury. There are many different types and classifications of pain.
Acute pain: Generally short-live, sharp, intense and starts suddenly
Chronic pain: Felt over a longer period of time, less intense and can be very uncomfortable
Referred pain: Pain that starts in one location, but is felt elsewhere in the body.
Phantom pain: Pain that is felt in an amputated limb
Another way to classify pain is by using the somatic, visceral and neuropathic categories.
Somatic pain: Nociceptive pain felt in the skin, tissue or muscles. The receptors for somatic pain are in the skin and the deep tissue.
Visceral pain: This pain arises from the body’s organs and feels more disperse than local
Neuropathic pain: This pain is due to nervous tissue pain, it is more complex than regular pain. Very often, the nerve fibers send incorrect signals to other pain centers of the body. The nerves in these cases might be damaged.
Different physical ailments and injuries will be associated with different types of pain sensations. There was one pain questionnaire that had over two hundred different ways to describe pain in order to help guide the therapist towards the correct diagnosis.
Stabbing, burning, pulling, cramping, piercing, itchy, pulsing, sore, numb, pins and needles, weak, tender.
The sports massage therapist or athletic therapist will ask for a description of the pain, but will also ask how often the pain is felt, how intense the pain is (on a scale of 1-10) at its worst and at its best, and will also ask how interfering the pain is in the day-to-day life.
Different types of pain will generally be associated with different injuries. The more intense the pain, the more chances of a tear or break in the tissues, the duller the pain, the more chances of a chronic injury or inflammation such as a tendonitis. If the pain is very intense and impeding, the first step of the rehabilitative process will be to manage the pain. The body uses pain as an alarm system to advise us that there is something wrong. In most cases, the more intense the pain, the more serious the injury will be. Once the treatment of an injury begins, the level of the pain will start to automatically decrease, relapses occurring of major changes to postures and compensations occur. For example, when someone breaks their legs, they will be in immense pain, but once the leg is casted, the pain will start to decrease even if the bone is still broken. Once the cast comes off, and range of motion exercises begin, there might be another spike in pain levels because the joints and muscles are asked to perform a movement that it has not performed in an extended period of time.
During the evaluation process, the therapist will perform a physical evaluation and will then analyze the results by comparing what was found physically with the pain descriptions and description of the mechanism of injury. This will help the sports massage therapist and athletic therapist understand if it is a muscle strain, sprain, a tear, a spasm, and imbalance, and if the injury is a result of an issue elsewhere in the body. At each stage, the therapist will use pain levels to determine progress, manual therapy techniques, exercises and stretches that are most appropriate.