Understanding Pain

Pain is a necessity; we feel pain in order to understand that something is wrong or damaged within our body and it signals us to take alternative and potentially protective actions. However, pain is also the most common reason people seek for medical care and ongoing pain can have negative consequences with a significant impact on overall health and quality of life.

Indeed, uncontrolled pain can severely impact quality of life through physical, psychological, social, and economic consequences. Patients suffering from severe pain frequently experience social isolation, dependence on caregivers and often suffer from impaired relationships with friends and family. Compared to healthy people, those suffering from severe pain are four-times more likely to suffer from depression or anxiety.

Understanding the complexity of pain

Pain is a complex phenomenon that can arise from different origins. Specifically, pain can be divided into the following key types: nociceptive, inflammatory and neuropathic.

  • Nociceptive pain is pain after tissue damage or injury, without a damage or impairment in the function of nervous system. Examples of this type of pain include burns, sprains, bone fractures, and bruises.
  • Inflammatory pain is pain associated with the immune system responding to tissue injury, such as in an infection or from joint inflammation in people with rheumatoid arthritis. Once again, the nervous system is not impaired in this type of pain.
  • Neuropathic pain is pain arising as a direct consequence of nerve damage or disease affecting the nerve fibers. Examples of neuropathic pain include nerve injuries, post-herpetic neuralgia (persistent nerve pain that occurs at the site of a previous attack of shingles caused by the chickenpox (herpes zoster) virus), and toxic and metabolic peripheral neuropathies (for example, nerve damage cause diabetes). Characteristics of neuropathic pain include burning, stabbing, tingling, pins and needles, as well as spontaneous (pain arising without stimulus) and abnormal responses to non-painful or painful stimuli.

Pain is a complex disease, and in many cases, patients suffer from painful conditions caused by multiple, co-occurring mechanisms. This mixture of pain types has been defined as the “mixed pain concept”.

Mixed pain is pain that is derived from both nociceptive/inflammatory and neuropathic origins. In many common conditions, such as low back pain and osteoarthritis, pain can have both nociceptive and neuropathic components. Often, the neuropathic component may go unrecognised, particularly with pain such as osteoarthritis with a strong history of being associated with purely nociceptive/ inflammatory mechanisms.

Management of mixed pain

The nature of mixed pain requires a combination treatment addressing both the nociceptive and neuropathic pain components. Neuropathic component of mixed pain could be adequately managed with medicine indicated to relieve neuropathic pain and medicine such as non-steroidal anti-inflammatory drugs (NSAIDs) help to relieve nociceptive or inflammatory pain in mixed pain.

Alternative treatment option such as neurotropic B vitamins (B1, B6 and B12) are available to target the underlying cause of the neuropathic pain which is nerve damage. Each of these B vitamins has seen found to have unique essential roles, which contributes to nerve function. Vitamin B1 is involved in energy metabolism. Vitamin B6 has an analgesic effect. Vitamin B12 ensures blood cell formation and prevents degenerative processes of the nervous system.

Neurotropic B vitamins can be used in combination with NSAIDs, to relieve mixed pain. While NSAIDs targets the nociceptive and inflammatory pain mechanisms, the neurotropic B vitamins nourish and help regenerate nerves.

Holistic approach to pain management addresses the emotional and psychological effects of pain, and can also include complementary and alternative approaches to pain control. Please consult your doctor for examination and diagnosis of pain, for a proper treatment plan based on your condition.


The information contained in this article is not intended or designed to diagnose, prevent, treat or provide a cure for any condition or disease, to ascertain the state of your health or be substituted for medical care. Procter & Gamble encourages you to seek advice from your doctor or healthcare professional if you have any questions or concerns arising from the information in this article.

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