Chronic Pain Clinic | Types of Pain

In the Pain Treatment Center, we see children, teens and young adults with a variety of different types of pain. These include:

Abdominal pain sometimes reflects another medical condition, such as inflammatory bowel disease, infections, celiac disease, various food allergies and increased stomach acid. These problems can be diagnosed with imaging scans and other tests. Often, however, abdominal may occur even though all of those tests are normal. In that case, the nerves of the gastrointestinal tract have become very sensitive and the pain itself has become the disease. This is known as functional abdominal pain. In this condition, sensations that are usually normal and not that bothersome, such as constipation, certain foods or stress, can serve as triggers and cause severe pain. People with functional abdominal pain often feel dismissed or disbelieved, but their pain is very real and can be disabling. Our center collaborates with the Division of Gastroenterology, Hepatology and Nutrition to address and treat this challenging condition.

Back pain is common among teenagers and adults. It can have many causes, including strain or overuse of the muscles and ligaments of the back and spine as well as hips and buttocks. A bulging disk in the spine, inflammation of the joints in the spine, and other conditions — such as arthritis or structural problems of the spine — can also lead to back pain.

Many children experience headaches at some point. Most have headaches only occasionally, but sometimes children have frequent headaches that disrupt their regular daily lives. Headaches have many different causes. They’re generally divided into two categories: primary headaches and secondary headaches. Secondary headaches are caused by another medical condition. The primary headaches that children and adolescents experience are most often migraine and tension type headaches.

Myofascial pain refers to pain in the muscles and surrounding soft tissues in the body. Pain can occur in a single muscle, muscle groups throughout various parts of the body. Muscles are often sensitive to the touch and can involve specific “trigger points,” which are areas in the muscle that are particularly tender. Causes of myofascial pain can be overuse of a muscle due to sports or a repetitive motion, or muscle strain. However, an underlying cause for the pain isn’t always clear. In myofascial pain syndrome, pain often persists or worsens and can interfere with many areas of life, such as going to school, enjoying activities, and even sleeping comfortably.

Neuropathic pain is nerve-related pain that results from abnormal pain signaling. It can have a number of causes, including injury, infection, chemotherapy treatment, neurological and metabolic diseases, and complex regional pain syndrome. Neuropathic pain can affect one nerve or many, but the intensity and severity of neuropathic pain don’t always match the initial injury. Patients typically describe neuropathic pain as burning, shooting, or like an electric shock or “pins and needles.”

Pelvic pain refers to lower abdominal pain and can be caused by injuries, muscle spasms, and strains involving the hips, low back, tailbone, and groin. It can also originate in the genitals and internal organs such as the colon and rectum, bladder, uterus, and ovaries. Pelvic pain can be accompanied by trouble voiding and pelvic floor dysfunction. Teenage boys may have scrotal or testicular pain, penile pain, or pain in the rectum, while the most common causes of chronic pelvic pain in teenage girls are menstrual pain and endometriosis.

Primary pain disorders (such as irritable bowel syndrome, fibromyalgia, and chronic headaches) are pain problems that are not usually caused by an underlying disease or injury. In pain conditions where there is an underlying disease, pain acts as a warning sign. Once the disease is cured or the injury heals, however, the pain goes away. In primary pain disorders, however, the nerves are hypersensitive, and pain is the disease and not a warning sign. In other words, primary pain disorders are false alarms. Even though they hurt, the pain is not harming the body. Many factors can make someone vulnerable to developing a primary pain disorder, including a previous injury or infection, a family history of primary pain disorders or even stressful emotional events. Sometimes, there is no identifiable cause.

Like adults, kids can experience pain following surgery or other invasive procedures. Most post-surgical pain resolves with time and treatment; however, a smaller percentage of young patients will continue to have pain that lingers weeks or even months after the procedure. The clinicians in Boston Children’s Inpatient Pain Service are skilled at managing post-surgical pain optimally, which has been shown to minimize the potential for chronic pain.