Pain : A latest guide for you

- Physiotherapist

A person at any age can experience pain. But it can also put health at risk. It is very hard to find who has not suffered from pain throughout their lifespan. Pain is such common suffering that many of us are interested in learning about it.

Suffering from pain seems a rational part of our biological life. According to a google search in 2021, one in every five people in America has been suffering from chronic pain, and eight percent of those people’s lives are hampering that pain daily, indeed.

Here is some important updated information about pain.

What is Pain

Pain is physical or psychological discomfort. The pain can feel steady, prickling, throbbing, stabbing, tingling, pinching, burning, and expressed in so many other ways. The intensity of pain might be sharp or dull like felt.  It can arise in any situation and anywhere. The perception of pain is thematic and varies from person to person.

Physical and Mental pain may vary from mild to severe and can be intense and chronic. You may feel the pain that may come and go or be constant. Continuously or temporarily. Our skin receives pain from its pain receptors persisting all over our body parts. These receptors carry out pain signals to our brain through nerve fiber.

Pain-related, so much research is available now. A recent research study in the UK says that if 100 people have an MRI, 90 percent of them will find abnormalities. Even if they don’t feel pain, your Physician will correlate your medical history and physical examination in detail also.

Pain is not a disease; rather, it brings you a warning sign. When we hurt, our body provides signals towards our brain through pain-type feelings. Pain tells us that we should take care or need attention. Sometimes, diagnosis of pain may be easy or difficult to resolve for Medical experts. Early diagnosis of root pain can solve many severe diseases of our body.

Pain in your body, either physical or mental, can interfere with daily living. Pain makes your life difficult on sociological, familial, and financial aspects as well. If you feel pain on the Head, backside of spine, neck, shoulder, knee, ankle, wrist, belly, don’t be scared by imagination. Consult with your Healthcare Specialist for any pain as soon as possible.

Signs & Symptoms

Signs & Symptoms of pain mean what expression you have seen and observed in the body. Pain is a symptom of some conditions in itself. Pain occurs due to swelling, nerve injury, diseases. Here are some symptoms associated with pain are as follows :

Physical Symptoms

RestlessnessTense body languageSad facial expressions
Fearful expressionGroaningPoor sleeping
Teeth grindingDecreasing activityA loss of function
CryingHeavy breathingtenderness

 Mental or Psychological Symptoms

 AnxietyNegative attitudeIrritabilityAnger
Mood swingsCrying spells Lethargy BoredomDull senses
Poor focusingEmptinessLoss of hopedistrust  
Guilt feelIsolationLoss of meaning 

Symptoms of nature of  ache

ShootingDull Aching BurningStabbing
NumbnessElectric shock likePiercingVibrating  


There are enormous causes of pain.  Our ache occurs during a long time sitting or working without changing our body position. But followings are the common causes of pain that

happens due to some variable factors such as :


Mechanical pain arising from the static body position, e.g., watching tv, laptop, mobile. High heel shoe, tight cloth, lack of pulling techniques invite back, heel, neck ache, etc.

Pain triggers as Inactivity of muscle, ligaments, bone. A research study conducted over 40,000 people where ninety percent of people were not doing minimal physical work or exercises and suffered muscle ache more than those doing minimal physical activity.


The things we use on a working station, such as a desk, chair, computer screen height, etc., are ergonomics. As a result, poor body positioning is one of the primary causes of pain.


When our age is progressing, our automatic degeneration of bones and muscles starts. This degenerative change of bone muscles becomes inefficient. Bones are prone to injuries like osteoarthritis of the knee or backache.

Inflammatory/diseases condition

Inflammation produces pain in the body, like Fibromyalgia, Lupus erythematosus, and arthritis are one of them.  Muscle cramps, migraines, rheumatic fever, and other conditions can also produce aches. Seasonal flu and coronavirus (COVID-19) make your muscles and joints ache for a month to a year. Seasonal flu and coronavirus (COVID-19) make your muscles and joints awful for a month to a year.


The hormone plays a vital role in causing pain. For example, lower belly cramps in every woman before or after a period. Insufficient amounts of iron, zinc, sodium, magnesium, potassium produce diseases, and muscle ache.  Vitamin D and calcium shortage produce ache on bone, teeth, muscles, ligaments. Besides, hormonal imbalance of the heart, kidney causes an unbearable body ache .

Mental and Physical  Stress

It is evident anxiety, depression and excessive physical stress causes pain. Excessive mental stress puts your health at stake. Mental stress creates muscle cramps, which leads to muscle joint ache. The stress hormone called cortisol releases excess energy that produces ache.

Sleep and pain have a strong association. Sleep disturbance will refrain your organ system from resting. When your organs can’t get rest, they will become irritated, imbalance. This imbalance of hormones produces pain in muscles.

When the main reason for ache remains latent, the pain cycle activates. Breakdown of the  root cause can only solve the pain cycle.

Description: Pain cycle

Source: PPS seminar


To make an answer on “what types or classification of pain” is not that simple. Pain can divide based on duration, nature, and origin of body tissue. Sometimes, pain can belong in more than one group, which is where the problem occurs.

Here, we try to simplify pain types such as the following:

Acute pain

Acute pain means when the duration of pain lasts a relatively short length of time. Duration of ache sustains from five minutes to five days or a month. Acute pain occurs due to soft injury, e.g., muscle sprain, ligament strain, headache, girls’ period pain. Sudden fall on the floor or twisting ankle belongs to acute injury or pain. When acute injury can’t heal and lasts, prolonging the time of more than a month can’t categorize it into acute pain.

Chronic pain

Chronic pain lasts over months to years. This chronic pain may present constant or intermittent. When acute pain fails to recover, then this pain belongs to chronic pain. Migraine, arthritis, fibromyalgia consider chronic pain as these last for months to years.

Nociceptive pain

In modern science, pain is one kind of signal that flows through some nerves called receptors. These receptors are known as  Nociceptors. These receptors are present in our body that triggers our brain.  As a result, we can feel pain. These Nociceptors are responsible for the root of the pain. For instance, if someone falls by twisting his leg, he may feel nociceptive pain—this kind of nociceptive pain associates with muscles, joints, ligaments, and bones. The pain may be acute or chronic. The feelings of this kind of pain may be sharp, throbbing, or dull aching in nature.

Neuropathic pain

Neuropathy means nerve-related issues. The nerve in our body works as transmitting wire from body parts to the brain and vice-versa. So, any injury or damage related to nerve tissue produces neuropathy pain. Nerve pain feels like burning, tingling, shooting, or stabbing. This kind of pain persists for a long time. Thus, neural pain belongs to chronic pain such as back pain and arthritis.

Radicular pain

Radicular pain means pain travels from neck to arm or back spine to leg. Radicular pain occurs when the spinal nerve is compressed due to traumatic or underlying neurological disease. Spinal cord lesions or sciatic pain are common examples of radicular pain. When the spinal disc between two spinal bones becomes compressed, the pain travels from the spine to the arm or leg is called radiculopathy.

Psychogenic Pain

Psychogenic pain arises from mental disorders or diseases. Anxiety, depression leads to body ache; the ache originated from a psychological issue. This is sometimes called Psychosomatic pain. Soma means body, so pain occurs through mental and impact on body tissue also.


Pain diagnosis is not very simple, especially for chronic pain. Pain sufferings vary from person to person according to the root cause. Healthcare Specialists will take your History, Physical examination, necessary blood, urine, stool, hormone test, radiological test, and so on as per accurate diagnosis of pain.


History taking is the most effective and conditional option for pain diagnosis. Proper history taking will shorten lab tests and ensure the correct identification of problems. Besides, patients can share their pain history while doing a medical assessment. The Medical textbook says sixty percent of diagnosis comes through taking a detailed history.

Physical examination

Your doctor will do a physical examination for a precise pain diagnosis. Physicians will inspect and touch, and this procedure is called Inspection and palpation. Any physical and mental pain must identify as the process as mentioned above. A doctor will ask you to perform a functional activity to see the movement limitation. Furthermore, how pain is hampering your daily task will be assessed in detail. These tests have recorded a correlation for pain diagnosis. Necessary laboratory and radiological investigation will further make a diagnosis.

Scale: Visual Analogue Scale is the most commonly used tool by the physician and Physical Therapist in chronic pain. This scale is for understanding the severity felt by the patient. The scale starts from zero to a maximum of 10. ‘Zero’ means no feeling of pain, and ‘ten’ is the highest worst pain.

Description: Pain scale which is called VAS, Visual Analogue Scale.

Pic courtesy: verywellhealth

The doctor asks the patient to mark pain intensity from no pain to worst pain.  The patients’ statement will accord exactly as per his description. After some treatment, either medication or physical therapy, again ask the patient how much pain is present. So, it is mainly the evaluation of pain along with the success of the management of pain.

Blood test

Your doctor can suggest blood tests to identify the root cause of the ache. Long-term body aches require some blood tests to rule out other diseases or health conditions. For example, long-term aches can arise from spinal nerve problems or liver, heart disease. Creatine kinase is an enzyme that traces excess in blood when inflammation of muscles. Blood tests are an important factor in the diagnosis of long-term pain.

Imaging test

X-Ray : It is the definitive test for diagnosis of acute or chronic pain. Pain in any body area such as arms, legs, the back spine needs X-Ray. Precisely, an X-Ray gives a clear whether bone fracture or lesions are present or not. The Barium meal X-Ray test has advised observing Stomach ache. Besides, osteoarthritis-related pain needs an X-Ray to see bones and joint conditions.

CT Scan : A computer Tomography scan is the updated imaging test. It shows the human body’s bone structure and soft tissue clearly and accurately. Most chronic pain diagnoses may require this scanning. Chronic Migraine, head injury, lung congestion in COVID-19 need CT scans.

MRI : Magnetic Resonance Imaging is the most diagnostic tool for assessing pain. An acute injury like knee twisting, spinal compression needs screening through this imaging. Chronic pain like ligament injury of any joint or organ affects how severe it can be through MRI.

NCV : Nerve Conduction Velocity test is to detect the extent of nerve damage. Ache is both acute and chronic, mostly associated with nerve injury. So the NCV test is very often an important test to diagnose neuropathy pain.

Moreover, Bone Mass Density(BMD), Electromyography (EMG), Exercise Tolerance Test(ETT) are the most common tests nowadays. To assess the condition of bone, muscle, nerve, and heart with chronic pain, these are very good options for diagnostic tests.

Pain management

Proper diagnosis of pain is the prerequisite to manage the pain successfully. Pain management strategy includes Drug therapy, Physical Therapy, Alternative therapies like Acupuncture, massage, and Surgery.

Drug therapy:

Non-steroidal anti-inflammatory drugs such as paracetamol, ibuprofen, aspirin, naproxen are the first-line drugs for acute and chronic pain management. Some anesthetics apply to the local area of the body in the form of spray, patch, injections, and cream. For example, lidocaine cream or patch apply for pain relief or local anesthesia.

Some stress-relieving drugs like antidepressants, anticonvulsants are also prescribed for acute and chronic pain management. Opioid pain killer drugs like Morphine, pethidine are used after surgical pain or acute traumatic pain like fracture, dislocation under a doctor’s supervision.

Physical Therapy:

Physical therapy is very much effective for reducing musculoskeletal pain. Physical therapy works effectively on spine injury, osteoarthritis of the knee, wrist, tennis elbow, frozen shoulder, etc. Besides, different electrical equipment,exercises are the core area of physical therapy strategy to manage acute and chronic pain.

Alternative therapy:

Acupuncture and gentle body massage  (certified massage experts) help reduce both acute and chronic ache. In addition, hot water therapy is very effective in osteoarthritis and chronic soft tissue injury, but it is not recommended to apply within 72 hours of acute injury.

Ice compression is so helpful in acute injury of traumatic pain in bone,muscle and ligament. For example, ankle twisting, ligament sprain and muscle spasm.


Surgery is required when all non-surgical management fails to recover from injury such as

  • Severe bodyache affects your daily living task,
  • Chronic  low back injury 
  • spinal nerve compression

Home management

Apply ice wrapping up a towel for any traumatic injury/pain, and apply the affected site for 10 minutes four times daily. It has proven that ice therapy will certainly subside your injury at the initial stage and prevent further damage of muscle, nerve, and ligament.Moist heat is much effective in chronic aches like arthritis, backache, shoulder injury. Applying heat will increase local blood circulation and sweep away your toxic chemicals on the injury site.

When to consult your doctor

Acute pain usually persists up to 72 hours or less. You can take Over-the-counter drugs such as paracetamol or ibuprofen to alleviate the pain. If ache interferes with your daily tasks for more than three days and home management(Non-traumatic case) couldn’t recover, then you should consult with a house Physician.

For chronic pain, you must visit the respective specialist doctor for long-term pain management. Chronic pain is usually related to complex health conditions, so it would be best to consult with a doctor.

The takeaway

Pain is not a disease. It’s a signal that your particular body tissue is injured. Pain is the language of any minor to major damage to your body, which should be taking care of immediately.

When acute pain is not properly treated, it turns into a chronic condition. So, to prevent permanent damage to your general function of bone, muscle, ligaments, organs, pain is the first and foremost warning signal.

Pain indirectly tells us to find out the root reason. Without addressing the root cause of the ache, our body tissue will somewhat get damaged permanently.

Finally, when you feel that discomfort should be addressed by a medical professional instantly, don’t delay rushing into the healthcare center or call the emergency phone of the national health service.

Frequently Ask Questions (FAQs) of Pain

1. When will I apply hot or cold on a painful area?

When pain is acute, the cold application is the best option. Heat can apply just after 72 hours on an injury site. The cold application is effectively recommended for any sports or traumatic injury and is the best option compared to heat.

Heat application is preferable for knee osteoarthritis pain, chronic backache, joint pain, and muscle spasms.

2. Which is the best pain reliever?

Ibuprofen is perhaps an effective pain reliever for headaches, minor trauma, or twisting injury. It resolves ache, swelling, and fever.  A research study suggests that 950 people participated in a questionnaire. All of them said ibuprofen is very effective and scored 9 out of 10.

3. What to do when pain-relieving drugs do not work completely?

Take a second opinion from the doctor when pain-relieving drugs don’t work completely.  Drugs can’t resolve all pain, and you need to take care of lifestyle modifications for mechanical backache.

4. How to manage pain during pregnancy?

Pain is common during pregnancy due to hormonal changes that produce back muscle discomfort. Consult with a Gynecologist regarding this issue, and she will refer you to a Physical Therapist for back injury management. Besides, you can take a hot bath, adequate rest, and relaxation exercises to relieve aches.

5. Chest pain mean heart related issues?

Not always. Due to gastritis, upper back or neck aches may refer to your chest area. So take plenty of water, avoid fried fast food to check your gastric discomfort, take a cold or hot bath to remove your ache. Consult with your doctor regarding a diagnosis of chest pain if it interferes with your daily living tasks.

Dr. Abid Kabir
Dr. Abid Kabir
Mohammad Abid Kabir is a licensed Physical Therapist in Bangladesh. He has vast clinical experience in treating critical patients on Orthopedic, Neurological, Geriatric, Pediatric, and Sports injuries. He is also a Public Health specialist with an emphasis on Disability issues and healthcare management. His post-graduate thesis was a KAP study on “Disability. “ Recently, he involves in Respiratory rehabilitation for Post-Covid-19 patients. He has been consulting on Medical, Health & Fitness issues for 14 years. Being passionate about Professional Blogging, Content Writing, and SEO works, he has been consulting for around ten years on Global media and the International market places.


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