Different pain conditions can cause different types of pain. However, due to the subjective nature of pain, it is difficult for both doctors and patients to know what makes us hurt in a given place at a given time. For those of us with generalized pain, that can make it really difficult to recognize when a new pain condition arises, and that means delays in diagnosis and treatment.
Something that can help is understanding the experiences of others when it comes to different varieties of pain. We can also learn the proper terminology about pain so that we can better communicate with our doctors.
I have experienced many different types of pain derived from: fibromyalgia, rheumatoid arthritis, myofascial pain syndrome, TMJ, carpal tunnel disorder, many injuries and more.
Some types of pain originate in the central nervous system (CNS), while others are structural pains linked to a muscle, connective tissue, bone or joint.
Pain of fibromyalgia
The pain of fibromyalgia is widespread and can affect any part of the body at any time. It can often be in certain areas or be completely random. It consists of innumerable types of pain. We have:
- Hyperalgesia, which does not cause pain on its own, but amplifies all pain signals;
- Allodynia, which is pain caused by stimuli that are normally not painful (such as a loose waist, moderate heat, or air that moves through the skin) and is often described as a sensation similar to a sunburn;
- Paresthesias, a type of nerve pain / abnormal sensation that includes tingling and burning;
- Ischemic pain, which is when the blood flow is low to an area and then rushes backwards, as when the foot falls asleep and then pins and needles are put on it;
- Fascial pain, which may be due to inflammation in the fascia (a network of connective tissues that covers and connects virtually everything in your body: muscles, tendons, ligaments, organs, etc.)
- Other types of pain that are not yet classified medically, but are commonly described by those of us who have the condition.
Ischemic, fascial and nervous pain will be discussed later in this article. You can learn more about types 1, 2, 3 and 6, including how they are treated, here:
- 7 types of fibromyalgia pain
The pain of fibromyalgia is unpredictable. Mine is currently in a long-term remission, but I used to have a throbbing, throbbing pain in my abdomen that seemed to bounce and bounce at random. One day, I could manage a good amount of effort before they started; The next, it may only be necessary to get out of bed and walk to the kitchen. Other times, they came out of nowhere, without being tied to the effort.
The flares completely removed me from the commission. I lay back in bed or on the couch all day, with a level 10 pain that felt like I was repeatedly stabbed. It was common for me to cuddle up in a ball and cry several times a day because I simply could not do anything else. My flares lasted 3 to 10 days and could hit at any time.
Much of the pain of fibromyalgia comes from nerves, so their descriptions are very similar to those of neuropathy (pain of damaged nerves). In fact, the drug Lyrica (pregabalin) is approved for neurology and fibromyalgia.
Nerve pain can cause tingling and burning, and it can feel like a bolt of electricity. Anyone who has touched a live wire or the prongs of a half-entry electrical outlet knows what that is like. Another good example of nerve pain is hitting your “funny bone”: it is not the bone that causes that characteristic and intense pain, it is the nerves.
The pain of my nerve (from the carpal tunnel, fibromyalgia and mild neuropathy in one foot and one leg) feels as if it is on the surface. When it’s soft, I sometimes confuse it with an itch, and then I really regret scratching it!
“Ischemia” means “inadequate blood supply”. It is also called “hypoperfusion.” The most common reference that most of us have is a foot or a hand that falls asleep. You do not feel much while the blood flow is low, but we all know what happens when you move or try to stand on the affected part. Oh!
In fibromyalgia, some research suggests low level ischemia in the muscles. That means they are deprived of oxygen, which weakens them. Then, when the blood flow increases, you can get that distinctive burning and stinging sensation.
Exercise increases blood flow to the muscles, which is a possible reason why proper exercise, tailored to your specific tolerance to exercise and your fitness level, can reduce the pain of fibromyalgia.
In my experience, ischemic pain is more similar to nerve pain.
Connective tissue pain
The tendons connect the muscles to the bones, while the ligaments connect the bones to each other. The fascia contains almost everything inside your body. Do you know the white layer of a chicken breast? That is the fascia.
In addition to having several connective tissue injuries, I have myofascial pain syndrome, which causes the lesions to heal improperly. That leads to trigger points, which can cause local pain and referral. (The trigger points are NOT the same as the tender points that are sometimes used to diagnose fibromyalgia.)
In my experience, the connective tissue pain is sore, with more intense pain when the damaged part is used.
Fibromyalgia does not usually cause joint pain. If you have joint pain from another source, such as arthritis, hyperalgesia will make it worse. However, if you have joint pain, and especially if those joints sometimes get hot and / or turn red, it is NOT due to fibromyalgia.
Joint pain, for me, is clearly different from the types of fibromyalgia pain. It feels as if it came from the deepest part of the body, it is extremely localized and feels hot. Sometimes I can feel that heat on the outside, like when it’s on my hands and knees, but sometimes it just feels hot on the inside.
My arthritis pain is very similar to my fascial pain, and that caused a great delay in its recognition. When my rheumatologist was convinced that something “new” was happening, he had hit most of my joints. Just a few years later, it is in all of them, to varying degrees. Even if today I found a treatment that would stop the progress of the disease, I would still be living with a lot of joint damage.
However, joint pain has been much easier to treat. In general, I have good results with ice and anti-inflammatories, which have little or no effect on the pain of my fibromyalgia. Narcotics also work better. These treatments do not necessarily make my joint pain go away, but they relieve pain and increase function. Steroid treatments also help.
Even so, the pain of arthritis is constant. The same places hurt every day, and although the intensity can increase and decrease to a certain extent, for me, it always stays within certain parameters. For example, I can trust that my hip pain will be a dull pain, somewhere between 4 and 6 on the pain scale, when I’m not very active. Then, a certain amount of movement will predictably increase it to a 9 or 10 and cause it to grip.
Note that I said “predictable”. That’s something nobody says about fibromyalgia.
Fibromyalgia vs. Arthritis
I will not say that one of these conditions is “worse” or “more painful” than the other. They are completely different and both vary considerably in severity from one person to another.
For me, fibromyalgia was completely debilitating during the outbreaks and caused considerable pain during the remissions. At the same time, it involved dozens of other symptoms, including cognitive dysfunction (fibro fog), fatigue, dizziness, environmental sensitivities and many other things that made life difficult.
However, from time to time I would really regress and I would feel pretty good. During those moments, I was able to do many things and I felt almost “normal”. With arthritis, I do not have those interruptions. I have better times and worse times, but the variation is much less. Arthritis also causes a much smaller set of symptoms.
With fibromyalgia, I was lucky and I found a combination of treatments that put him in remission. I still have some symptoms, but they are much milder. So far, with my arthritis, I have not been able to tolerate treatments that slow the progression of the disease. I am able to treat pain, but my immune system continues to damage my joints.
However, that is just my experience. Someone else may be able to decrease arthritis, but be powerless against fibromyalgia. I am sure that there is every possible combination of results. Each case is different.
Recognizing New Pain
The important thing for each one of us is to pay attention to our bodies. Know your types of pain and what seems to trigger them. That way, if something else comes up, you can recognize it before. It can help keep a symptom diary.
When approaching your doctor about new types of pain, be sure to emphasize that it is new and different from your other pain. Describe its nature (pain, burning, stabbing, etc.) and, if it is similar to a type of pain you have had before, mention that. You want to make sure that your doctor understands that it is not a worsening pain of fibromyalgia, so you will be willing to investigate.