NOCICEPTIVE AND NEUROPATHIC PAIN OFTEN COEXIST
- Two main types of pathophysiology are often the cause for pain in the majority of patients—nociceptive pain and neuropathic pain1
COMMON TYPES OF CHRONIC PAIN
Below are types of chronic pain, including diabetic peripheral neuropathy and conditions that originate or are common to the low back. Patients with chronic pain conditions may have both a neuropathic and a nociceptive component.2
DIABETIC PERIPHERAL NEUROPATHY (DPN)
A complication of diabetes in which high blood glucose may damage the tiny blood vessels carrying oxygen and nutrients to the small nerves in the hands and feet.3
INTERVERTEBRAL DISC DISEASE
A condition typically caused by aging in which discs in the vertebral column deteriorate or herniate, causing them to lose fluid, elasticity, and shock-absorbing capabilities.4
Nerve damage typically caused by inflammation or impingement of a nerve root, causing weakness and/or pain radiating the length of the nerve.5
A form of radicular nerve pain, often caused by pressure on the nerve root at L5‑S1, causing pain that radiates down the back of the leg.5
There are several forms of arthritis of the spine (known altogether as spondyloarthropathies). These include:
An inflammatory disease in which the ligaments and bones of the spine fuse together, resulting in a stiff, fused, painful spine.7
- National Pharmaceutical Council and Joint Commission Pain. Current understanding of assessment, management, and treatments. American Pain Society website. http://americanpainsociety.org/uploads/education/section_4.pdf. Accessed June 27, 2018.
- Pergolizzi JV, Schung SA, Raffa RB, et al. Tapentadol and dual pain inhibition: a new strategy for a pain relief in Australia. Chronic Dis Int. 2015;2(1):1011.
- Toft D. Diabetic neuropathy causes. Endocrineweb. http://www.endocrineweb.com/guides/diabetic-neuropathy/diabetic-neuropathy-causes. Updated November 24, 2015. Accessed March 17, 2016.
- Intervertebral disc disease. In: Lewis S, Dirksen S, Heitkemper M, Bucher L. Clinical Companion to Medical‑Surgical Nursing. 9th Ed. St. Louis, MO: Elsevier Health Sciences; 2014:362‑363.
- Laroche F, Serge P. Managing Sciatica and Radicular Pain in Primary Care Practice. New York, NY: Springer Science & Business Media; 2013.
- Arthritis and diseases that affect the back. Arthritis Foundation website. http://www.arthritis.org/about-arthritis/where-it-hurts/back-pain/causes/back-arthritis.php. Accessed March 17, 2016.
- Stedman’s Medical Dictionary. 27th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006.
- Frymoyer JW. Degenerative spondylolisthesis: diagnosis and treatment. J Am Acad Orthop Surg. 1994;2(1):9‑15.