[BLANK_AUDIO] So now we, we talk about types of pain. And generally when we talk about types of pain we're referring to, first of all somatic pain. Second vsceral pain, and the third type that I want to mention is something call the neuropathic pain. So when you think somatic pain, what do you thing of, when you hear that word somatic? [BLANK_AUDIO] Stephanie,. >> Maybe like muscles, like [INAUDIBLE]. >> Yes, yes, what you were you going to say Lauren? >> Oh, that you can pinpoint where the pain is. >> Oh, that's really true too. Exactly. So when we think somatic, that word somatic refers to the body, and so when we think of somatic pain, we're thinking of pain that we can pin point somewhere in the body, so it's more localizable, right? And it's pain that's associated with the skin, the mucus membrane, line openings of your body muscles, joints. Those are the structures that are usually involved in somatic pain sensations, and this type of pain is easier to localize, and it can often be replicated. So maybe you go to see your healthcare provider, because you experience pain. And you'll describe the pain to your healthcare provider. And then, they will replicate, you know, no more than necessary, but they'll replicate the pain, just so they can help diagnose what's going on a little bit better. This pain is it can be reproduced by touching the affected body area, or moving the affected body area. So when we think about somatic pain, we can even be more precise, and we can think of it as a superficial somatic pain, or a deep somatic pain. So, superficial somatic pain, these are the ones that, you would, experience when you damage the skin or very superficial structures on the body. And usually the signals that are associated with superficial somatic pain are mechanical or thermal. And we experience them as sharp rapid onset pain, right? Deep somatic pain is the kind of pain that you might experience in muscles, and in joints, and it's more of an aching, throbbing, burning kind of pain. An exception to that rule, would be, has anybody ever pulled a muscle? When we pull a muscle, that ends up being a sharp kind of pain at the, at the time of the injury. And then later we experience it as a deeper kind of throbbing pain, right? Okay, so visceral pain is the second type of pain and I find it very interesting. Because visceral pain is associated with the organs inside the body, right? Those organs contain nociceptors in their walls. So when there are stimuli occurring that could be damaging to the internal organs, and the nociceptors will be activated. And they will in turn activate the type C fibers that innervate the organs, okay? The pain, that is visceral pain. Is also a deep throbbing kind of pain typically. And it actually often triggers through reflexive neural pathways visceral pain can trigger nausea, vomiting, and other symptoms for us. But the interesting thing about visceral pain is that we really can't localize it very effectively. And, often what happens is that because the type C, first ordered neurons that are carrying the stimulus information toward the spinal cord. They run in the same nerve fibers as, type A beta fibers, from the same general region of the body. Often our brain will interpret visceral pain, as occurring at some spot on the body surface. Not near the organ, right? So what's the most common type of visceral pain? Or I'm sorry, a visceral pain that you've heard of as being experienced at the body surface? Lydia. >> Could that be like a heart attack, being [INAUDIBLE] pain in the left arm or something? >> Exactly. So people who are having a heart attack will also, will often describe the pain as radiating down the left arm, or being you know, localizing it to their shoulder. That experience is something that we call referred pain. And it occurs when nociceptors in visceral organs are activated. We often perceive the pain as occurring on the body surface rather, than in the visceral organ. So, so a fairly common phenomenon, or not uncommon phenomenon might be the best way to say it. And then the third type of pain is something called neuropathic pain. All of the pain i've talked about so far involves activating those nociceptors. Neuropathic pain occurs because, nerves themselves are damaged, or nerve fibers are damaged. So, there's no nociceptor involvement. It's simply that the nerve damage creates the perception of pain. The damage can be due to trauma or surgery. It can be due to chemotherapy, cancers, there are lots of different causes for it. There are some common conditions, that really fall into this category of neuropathic pain. Are you aware of any of them? Stephanie. >> Diabetes. >> Diabetes can produce, produce a diabetic neuropathy, correct. Which is damage to nerve fibers. That ends up creating perceptions of pain in the affected, usually in the affected limb or extremity, right? Anything else you can think of? What happens when someone loses a limb or part of a limb? What do they experience? [INAUDIBLE] >> Phantom limb pain. >> Yes, exactly. Phantom pain or phantom limb pain. What happens is in the trauma or in the surgery that follows the trauma there is nerve damage that continues to reverberate for, for the person. And they experience what we call phantom limb pain or phantom pain. Anything else you can think of? What's this condition where we can press the, the nerve that passes, yes? >> Carpal tunnel syndrome. >> Carpal tunnel syndrome. There, we're creating so much pressure on a nerve that we're actually interfering with its function, and we perceive pain associated with that. Can you think of anything else? What happens when someone has a herniated disc in their vertebral column? And they compress a nerve? All right? That kind of nerve compression can create pain. That's another example of a neuropathic pain. So, you will encounter that type of pain as well. I think you're going to enjoy the next lectures, because they're actually go, going to be lectures that are conducted as interviews. In which you're going to all learn something about the subjective components of pain. Specifically we're going to be dealing with cultural and soc, social modifiers. And we'll be discussing pain assessment and some of the therapeutic implications of pain. [BLANK_AUDIO]
