Quality of Vertebral Pain

[spaceangelz]

Hi all,
I'm a physiotherapy student and have had a few different opinions regarding the quality of different types of pain for patients with: discogenic, facet joint, ligamentous, muscular pain.

Can someone please clarify what type of pain (eg. sharp, shooting, dull, stabbing, ache) is generally associated with these type of issues?

Thanks

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[gcoe]

Hi Spaceangelz

Most good musculoskeletal physiotherapy texts describe the types of musculoskeletal pain in the Subjective examination chapters For example have a look at Petty and Moore (2001) summary table on page 13

Neuromusculoskeletal examination and ... - Google Books

However this is really just a starting point and the danger is an oversimplification of the experience of pain: (eg Shooting pain is always neurogenic pain etc). These simplistic descriptions of pain types fall apart in real life, especially as we face patients with chronic pain syndromes, yellow flags and emotional aspects of pain, neuropathic pain etc.

To understand pain better one needs to do considerable study. Several good manual therapy texts will have informative chapters on pain which may be a good starting point. There is much we now know about the neurophysiology and psychology of pain but this can’t be summarised in a few paragraphs.

One useful site is the International Association for the Study of Pain.

International Association for the Study of Pain | Welcome to IASP

There are all sorts of resources, interest groups, tutorials and professional development areas on the site. For example you could familiarise yourself with some of the basic terminologies of types of pain:

Allodynia, Neuritis Neuropathic Pain Dysesthesia Hyperesthesia Pain Hyperpathia Hypoesthesia Peripheral Neurogenic Pain Peripheral Neuropathic Pain. Each of these pain experiences have a distinct description.

Here is an interesting study that relates to the nature of lumbar spinal pain.

Robinson, J. R. (2003). Lower Extremity Pain of Lumbar Spine Origin: Differentiating Somatic Referred and Radicular Pain. Journal of Manual & Manipulative Therapy, 11(4), 223-234

I know this is a long winded response but I am hoping you will consider taking a deeper approach to understanding the nature of pain and what patients are expressing as they describe their pain to you. Best of luck with your studies.