Pain: Not Fun but Actually Pretty Helpful 

By: Kyra Corradin, PT, DPT, YTT

Pain is never fun, but believe it or not, it has a pretty useful job to do. Think of it as your body’s built-in warning system—it’s how your body tells you when something’s wrong and nudges you to take action. In a way, it’s like your internal self-preservation tool, helping you navigate the world safely. But here’s the kicker: everyone experiences pain differently, depending on a mix of biological, emotional, and social factors. Sometimes, people feel pain with no obvious injury, which is a big reason why we now understand that pain, every type of pain, is actually an output from our brains! 

So, what if we didn’t feel pain at all? Let’s take a look at people with Congenital Insensitivity to Pain (CIPA), a condition where someone is born without the ability to feel pain. It might sound like a superpower, but it’s actually incredibly dangerous. Without pain, they don’t know when something’s wrong and are more prone to serious injuries. It’s common for people with this condition to suffer serious burns, untreated infections, or even brush their teeth so hard that their gums bleed. 

The 3 Main Types of Pain 

Let’s break it down into three main types: nociceptive pain, neuropathic pain, and centralized pain. Trust me, knowing what’s going on under the hood can be surprisingly helpful!

1. Nociceptive Pain

First up, we’ve got nociceptive pain—the kind that kicks in when your body’s tissues (think skin, muscle, bones) get damaged or inflamed. This pain starts with special nerve receptors called nociceptors that are scattered all over your body. These little guys are like your body's detectives, picking up on changes in things like temperature, pH, inflammation chemicals- really any signs that tissue is in its typical balanced state. When they’re activated, they send a “heads up!” signal to your brain. Your brain compares frequencies and intensity of these signals to past experiences and decides whether it’s something you should worry about. If your brain decides it is something to worry about. Your brain creates a sensation of pain. 

For example, if you touch something hot, a temperature-sensing nociceptor gets triggered. Your brain takes that info and compares it to your past burn experiences. It decides, “Yep, this is gonna hurt,” and generates that familiar pain sensation, making sure you pull your hand away before your skin starts to fry.

2. Neuropathic Pain

Next, we’ve got neuropathic pain—this one is all about nerve trouble. It happens when something damages the nerve fibers themselves, rather than the surrounding tissues. This kind of pain can come from trauma to a nerve or from things like nerve compression/radiculopathy, and even diseases that affect nerves like diabetes, Parkinson’s Disease, or multiple sclerosis. Since nerves stretch all over your body, it’s harder to pinpoint where exactly the pain is coming from, and it often feels burning or electrical. 

3. Centralized Pain

Lastly, let’s talk about centralized pain, which is a bit more mysterious. This happens when your central nervous system (the brain and spinal cord) gets sensitized to pain signals. Basically, the brain becomes a little too sensitive and starts reacting to nerve signals more intensely than it should. Imagine if your fire alarm went off for no reason—something’s wrong, but it’s not the house that’s on fire; it’s the alarm itself that’s malfunctioning.

Centralized pain often starts after an injury or acute pain that never fully heals. The original pain doesn’t go away, and eventually, it sets off a loop where the nervous system just keeps cranking out pain signals, even though the tissue isn’t badly damaged anymore. And that makes this kind of pain especially tricky to treat.

A Little Overlap!

Now, it’s important to remember that these types of pain don’t always stick to their lanes. You might have nociceptive pain from an injury and neuropathic pain from nerve damage at the same time. Or maybe you’re dealing with centralized pain, but there’s still some underlying tissue damage or inflammation. Your body is complicated, and pain can be a bit of a mix-and-match situation.

So, next time you’re dealing with pain, remember: it’s not just about “hurting”—it’s your body trying to tell you something important. Whether it’s nociceptive, neuropathic, or centralized pain, understanding the root cause is key to finding the right treatment. No matter what type of pain you’re experiencing, physical therapy can be a game-changer. A skilled physical therapist can help you get to the bottom of your pain, improve mobility, and develop a plan to manage or even eliminate it. Don’t let pain hold you back—get the support you need to feel better and get back to doing what you love.