Pain is a complex phenomenon. It certainly has physical causes, but has emotional and psychologic components too. How each individual responds to pain is also complex. The extent of disease and the type of pain contribute to the painful experience. But pain is also modified by remembrances of past painful experiences, the special meaning of pain to each individual, the expectations of family and friends, religious upbringing, racial background and personal coping skills and strategies.
Cultural background and beliefs also play a part. Certain cultures teach tolerance of pain or that the outward expression of pain is inappropriate. People from these cultures bear their pain without complaining or even expressing their needs. They appear to have a higher threshold or tolerance to pain. Other cultures readily and outwardly express painful experiences and appear to have a low threshold or tolerance.
Types of Pain Not all pains are the same. There are two kinds of physical pain, and recognizing their differences is the key to selecting appropriate treatment plans. Patients generally use different words to describe these two types of pain. One type is called somatic pain and is often described as sharp, dull, throbbing or aching. A second type, neuropathic pain, is often described as sharp, shooting, electrical or lightning-like.
Most pains we experience in our daily lives—the pains from cuts and bruises or pains from broken bones or surgery—are usually somatic pain. Some pains from bone cancer or cancer of abdominal organs such as the stomach or colon may also be somatic. These somatic pains usually respond to narcotic therapies and are well suited to treatment according to guidelines for cancer pain management developed by the World Health Organization (WHO).
