Pain is typically classified into three main types based on its underlying cause and characteristics.
The three types of pain are:
- Nociceptive Pain
- Neuropathic Pain
- Nociplastic Pain
Nociceptive pain
Nociceptive pain is our body’s natural response to actual or potential tissue damage. This happens when our pain receptors, which are called nociceptors, are activated by harmful stimuli. This type of pain helps protect our bodies by signalling that something is wrong.
Nociceptive pain can be somatic or visceral. Somatic pain comes from our skin, muscles, or joints and is sharp and localized, whereas visceral pain comes from our internal organs where the pain is dull, we may experience cramping, and it is more diffuse.
Nociceptive pain is typically acute, resolving as the injury heals, but can become chronic if the underlying cause persists.
Cuts, burns, inflammation, arthritis, fractures, or appendicitis are typical causes of nociceptive pain.
Neuropathic pain
Neuropathic pain arises from damage or dysfunction in our nervous system, either in the peripheral nerves or the central nervous system, which includes our brain and spinal cord.
Unlike nociceptive pain, neuropathic pain is not caused by tissue injury but by abnormal nerve signaling. It often feels like burning, shooting, electric shocks, or tingling, and may occur even without an obvious trigger.
Common causes include diabetes (diabetic neuropathy), shingles (postherpetic neuralgia), and nerve compression, like sciatica or a spinal cord injury.
Neuropathic pain is typically chronic and can be difficult to treat.
Nociplastic pain (or Central Sensitization Pain)
Nociplastic pain refers to pain that results from altered or abnormal processing of pain signals in our central nervous system. There is usually no clear evidence of tissue damage or nerve injury.
Nociplastic pain is often widespread, persistent, and associated with other symptoms like fatigue, sleep issues, or mood and cognitive disturbances.
This type of pain is seen in conditions such as fibromyalgia, some chronic back pain, and irritable bowel syndrome.
Because it is not linked to visible injury or nerve damage, diagnosis can be challenging, and treatment typically involves a combination of education, exercise, and psychological support.
Managing nociplastic pain
Managing nociplastic pain (e.g., in fibromyalgia, IBS, chronic fatigue syndrome) involves addressing both the central nervous system sensitivity and the whole-person experience of chronic pain.
Because it’s not caused by tissue or nerve damage, standard painkillers are usually ineffective. Instead, a multimodal, lifestyle-centred approach is most effective.
Best lifestyle support for nociplastic pain includes:
- Regular Low-Impact Exercise like walking, swimming, yoga, tai chi, and stretching. Avoid doing too much too quickly to avoid
- Optimize Sleep. Poor sleep worsens central sensitization and pain perception, so a consistent sleep routine is vital. Avoid screens before bed and avoid caffeine/alcohol late in the day.
- Stress Reduction & Nervous System Regulation. Chronic stress amplifies pain perception and so helping to calm the nervous system can help to reduce symptoms. Meditation, deep breathing, biofeedback, vagus nerve stimulation and mindfulness practices can be helpful. Therapies like Cognitive Behavioural Therapy (CBT) or Pain Reprocessing Therapy can also help to reframe thought patterns and calm the nervous system.
Listen to my interview with Brad Kirsten from Radio Cape Pulpit on 5 June 2025 to learn more. Listen to my next interview on Thursday at 7.45am.