joneskurian.com - About Pain
joneskurian.com - Consultant Pain Medicine

The Puzzle of Pain
"Pain is an unpleasant sensory and emotional Chronic pain is a disease of the central nervous system.  It is defined as “pain without apparent biological value that has persisted beyond normal tissue healing time”  It is also defined as pain that either persists beyond the point that healing would be expected to be complete (usually taken as 3-6 months) or that occurs in disease processes in which healing does not take place. The pain may be continuous or intermittent. Chronic pain can be experienced by those who do not have evidence of tissue damage or biological reason for pain (International Association for the Study of Pain, 2007).   This ‘unknown cause’ factor often results in difficulty in reaching a diagnosis.This type of pain can be nociceptive, or can be neuropathic i.e. handled by a dysfunctional nerve or cluster of nerve signals. People living with chronic pain often report hyperalgesia (increased sensitivity to pain), allodynia (heightened pain response to usually non-painful stimuli) or dysaesthesia (unpleasant abnormal sensations).  Chronic pain can also arise from other types of pain.

Types of Pain 
Pain can be classified by the type of pain or by body region. Classification by pain types includes:

Neuropathic pain: burning, stabbing, tingling, insect crawling, shooting, associated with allodynia, hypersensitivity or other sensory changes.

Nociceptive pain: aching, boring, worse on movement, anatomically defined, fluctuates in severity.

Mixed i.e. a combination of both neuropathic & nociceptive pain symptoms.

Visceral pain: dull, diffuse, ill-defined.

Autonomic symptoms: colour and temperature changes, sweating, trophic changes.




Pain is the body’s alarm system. It tells us when something is wrong. It is very helpful when it works well. But sometimes the alarm never shuts off. And sometimes the alarm system breaks—it sends signals even when all is well. This is called chronic pain.

One difficult thing about pain is that it can’t be measured. No test or device can measure how much you hurt. That’s why most doctors agree that “pain is what the patient says it is.” But even describing pain can be hard.
Pain comes in many “flavors”— burning, shooting, dull, sharp, prickly, throbbing, and many others. Sometimes the source of pain
is clear. But often a physical cause cannot be found. Some people worry that a doctor will think their pain is “all in their head.”
Most  doctors know better. They will take your pain seriously and work hard to find a solution.

Pain Medicine is a fairly new medical speciality.
It is focused on helping people in chronic pain.
Pain specialists are physicians with extra training in pain medicine.