Pain Lah!
VS
ELECTRIC PAIN
Pain can be excruciating, isolating and difficult to manage. Naming it, knowing it, and being able to describe it to your doctor will help connect you with effective treatment and a management plan.
QUICK PAIN ASSESSMENT QUIZ
Is the pain you’re experiencing nociceptive (regular) pain or neuropathic (nerve) pain?
Take the quiz below to find out.
QUIZ: NEUROPATHIC VS NOCICEPTIVE PAIN
SCORING:
If you answered ‘yes’ to questions 1-5, it suggests that you experience symptoms consistent with neuropathic pain.1-3
If you experience pain that is more acute, directly related to an injury, and improves as the injury heals, it might be nociceptive pain2,3
NOTE: This quiz is not a definitive diagnostic tool but rather a guide to help identify potential symptoms of neuropathic pain. A healthcare professional should be consulted for an accurate diagnosis and treatment plan.
PAIN TYPES
NOCICEPTIVE PAIN
This the most common kind of pain. It’s like your body’s alarm system. When you get hurt, like a bruise or a burn, special sensors in your body tell your brain “Ouch, that hurts!” This pain usually goes away when you heal.2,3
NEUROPATHIC PAIN
It is a type of pain that happens when your nerves get damaged or don’t work properly. This can be like burning, stabbing or tingling pain, and it can last a long time.4-6 It occurs due to inflammatory response that is harmful to the body.7
EASY WAY TO REMEMBER THE DIFFERENCE
• Nociceptive pain: Comes from injuries you can see or feel, like a sprained ankle.
• Neuropathic pain: Comes from problems with your nerves, even if you can’t see why it hurts.
Both types of pain are your body’s way of saying something’s not right, but they happen for different reasons.
If either type of pain is severe, causing you distress, or interferes with your sleep, see with your doctor.
It is particularly important to see your doctor if it is neuropathic pain. Neuropathic pain can be very debilitating and have a sudden onset.
To access
that specifically targets neuropathic pain you need to see your doctor, as it is only available with a prescription.
To access
Treatment
that
that specifically targets neuropathic pain you need
specifically targets neuropathic pain you need to see your doctor, as it is only available with a prescription.
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to see your doctor, as it is only available with a prescription.
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PAIN EMOJI MAP
1. Use these emojis to describe your pain to your doctor:
Burning sensation4,5
Burning sensation 4,5
Shooting, tingling or electric
shock-like sensation 4,5
Sharp, stabbing sensation 4,5
Pins and needles
sensation 4,5
Numbness or loss of
sensation 4,5
Crawling ants sensation 4,5
Stinging bees
sensation 4,5
2. Drag the appropriate emoji to the area where you feel pain. Once done, screenshot/take a picture of the map to show to your doctor.
3. Rate the intensity – After dropping the sensation emoji in the correct position, rate the intensity of pain you are experiencing there by dragging on the face emoji that is the best match to the pain level.
Once done, screenshot/take a picture of the pain level to show to your doctor.
COMMUNICATING WITH YOUR DOCTOR
When describing your pain, remember to:
1. Be specific about the location
2. Use descriptive words (burning, shooting, etc.)
3. Explain how it affects your daily activities
4. Mention any triggers or relieving factors
NEUROPATHIC PAIN
Example: “Doctor, I’m experiencing a burning sensation (
) in my left foot that shoots up my leg (
). It’s about a 7 out of 10 in intensity
Example: “Doctor, I’m experiencing a burning sensation (
Example: “Doctor, I’m experiencing a
burning sensation (
) in my left
) in my left foot that shoots
foot that shoots up my leg (
).
It’s about a 7 out of 10 in intensity and gets worse when I walk.
). It’s about a 7 out of 10 in intensity and gets worse when I walk.
The pain is constant and affects my sleep.”
By using these emojis and specific descriptions, you can help your doctor better understand your pain and develop an appropriate treatment plan.
DIAGNOSING DIABETIC RETINOPATHY
If diabetic neuropathy is diagnosed and treated early, the chances of controlling symptoms and limiting the damage are better. Stay alert for signs and symptoms of diabetic neuropathy.8,9
For example, a small sore that does not get better can become an ulcer–unattended foot ulcers can become gangrenous (where the tissue dies) and require surgery or foot amputation. This can be prevented through early detection and treatment.8
COMMUNICATING WITH YOUR DOCTOR
When describing your pain, remember to:
1. Be specific about the location
2. Use descriptive words (burning, shooting, etc.)
3. Explain how it affects your daily activities
4. Mention any triggers or relieving factors
NEUROPATHIC PAIN
Example: “Doctor, I’m experiencing a burning sensation (
) in my left foot that shoots up my leg (
). It’s about a 7 out of 10 in intensity
Example: “Doctor, I’m experiencing a burning sensation (
) in my left foot
that shoots up my leg (
). It’s about a 7 out of 10 in intensity and gets worse
when I walk. The pain is constant and affects my sleep.”
By using these emojis and specific descriptions, you can help your doctor better understand your pain and develop an appropriate treatment plan.
DIAGNOSING DIABETIC RETINOPATHY
If diabetic neuropathy is diagnosed and treated early, the chances of controlling symptoms and limiting the damage are better. Stay alert for signs and symptoms of diabetic neuropathy. 8,9
For example, a small sore that does not get better can become an ulcer–unattended foot ulcers can become gangrenous (where the tissue dies) and require surgery or foot amputation. This can be prevented through early detection and treatment. 8
RESOURCES
How Does Pain Occur?
Signs of Inflammation
What is Neuropathic Pain?
Why Most Painkillers Don’t Work For Nerve Pain
A Handy Guide To Describing Your Pain
Living with Neuropathic Pain
“Tahan” Pain Is Still Pain
How Doctors Treat Inflammation-Related Pain
TREATMENT
Neuropathic pain is not like other forms of pain, such as a pulled muscle or strain in which common medicines like paracetamol and/or ibuprofen can help. The medicines which are prescribed for neuropathic pain are different and can take longer to work.
When you start treatment with medicines for your neuropathic pain you may begin on a low dose, which your doctor may choose to increase over time, gradually, until you gain the most benefit.
Some people find that they do not wish to increase the dose as they may experience side effects on a higher dose.
The most common side effects of medicines recognised as first line therapy to treat neuropathic pain include tiredness, dry mouth, blurry vision, loss of appetite and drowsiness among others. If you are experiencing these side effects, please have a discussion with your doctor.
Do not drive or operate machinery if you experience drowsiness or blurred vision and follow the advice given by the doctor or pharmacist.
Everyone is different and responds differently to drug treatment – some people find that their medicine starts to help straight away, and for others it takes a bit more time. It is important to keep talking to your doctor and /or pharmacist about how you are feeling, whether things are improving, and what you can do to help yourself.
If your symptoms worsen at any point please make sure to contact your prescribing doctor.
YOUR MANAGEMENT PLAN
Symptoms of neuropathic pain vary as follows. In addition, since neuropathic pain can progress chronically, it is often accompanied by depression, anxiety, and sleep disorders.
01
Adequate physical activity and exercise regimen
Physical activity and exercise therapy for people with chronic pain may include aerobic exercise, strength training, and motor conditioning therapy.
Physical activity and exercise therapy canhelp improve pain intensity, physical dysfunction, and mental health.
02
Lifestyle changes are needed
In pre-diabetic patients, lifestyle modifications such as eating habits and exercise improved the components of metabolic syndrome, which are presumed to be related to the development of peripheral neuropathy.
03
Have a positive mindset
Patients with neuropathic pain often experience depression, sleep disorders, and anxiety.
When these symptoms are also treated, better pain control is more likely to be expected, so a combination with psychological therapy and pharmacotherapy may be helpful.
References
1. Finnerup NB, Haroutounian S, Kamerman P, Baron R, Bennett DL, Bouhassira D, et al. Neuropathic pain: an updated grading system for research and clinical practice. Pain. 2016;157(8):1599-606.
2. Basbaum AI, Bautista DM, Scherrer G, Julius D. Cellular and molecular mechanisms of pain. Cell. 2009;139(2):267-84.
3. International Association for the Study of Pain. IASP Terminology.
4. The voice of the patient. U.S> Food and Drug Administration. https://www.fda.gov/files/about%20fda/published/The-Voice-of-the-Patient–Neuropathic-Pain-Associated-with-Peripheral-Neuropathy. pdf Published 2017. Accessed August 25, 2021.
5. Ang L, Cowdin N, Mizokami-Stout K, Pop-Busui R. Update on the management of diabetic neruropathy. Diabetes Spectr. 2018;31(3):224-233.
6. Raja Srinivasa N; Carr Daniel B; Cohen Milton; et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. The International
Association for the Study of Pain (IASP). 2020; 161(9):1976-1982.
7. Stanos S, Brodksy M, Argoff C, et al. Rethinking chronic pain in a primary care setting. Postgrad Med. 2016; 128(5):502-515.
8. Centers for Disease Control and Prevention. Diabetes and Nerve Damage. Available from: Diabetes and Nerve Damage | CDC. Last Accessed on July 19, 2023.
9. Bouhassira D, Attal N. The multiple challenges of neuropathic pain. Neurosci Lett. 2019;702:6-10
