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Chronic Nociceptive Pain- Causes, Risk factors, Symptoms and Treatment

Pain, none of us like this agonizing perception of getting hurt or injury. The intensity of pain might differ and it is very important to determine the exact cause of pain in order to get it treated. Chronic pain is categorized in 4 categories

  • Nociceptive
  • Neuropathic
  • Mixed
  • Epidemiologic studies

Here we are going to understand all about Chronic Nociceptive Pain which is again categorized in three categories

  • Cutaneous
  • Somatic
  • Visceral

Nociceptive pain starts as soon as you get a tissue injury. If healing of the tissue remains inadequate and tissue trauma exists for more than six months the pain becomes chronic. When the nociceptive pain reaches the chronic state it secrets neurotransmitters continuously within injured healing tissues or scar tissues. Nociceptive pain goes off only when the damage caused to the tissue is healed

Chronic Nociceptive pain – Causes and Risk Factors

Nociceptive pain is considered as acute pain if it remains for 3-6 months. If it continues beyond 6 months it becomes chronic.

Nociceptive pain- Cutaneous

  1. Confined within subcutaneous tissue and skin
  2. Tissue trauma like abrasion, laceration, repeat injury- it increases the intensity of pain and its duration, non healing skin burns, skin ulcers, bruise, bump or inflammations

Nociceptive pain- Somatic

  1. Gets triggered due to muscle or ligament trauma or injury, joint dislocation, fracture, tendon rupture, muscle tear, injury etc.,
  2. Sprains : to the muscles or ligaments
  3. Arthritis: osteo or rheumatoid arthritis
  4. Inflammation : of muscles followed by infection or injury
  5. Muscle disease : myofascitis, myofascial pain, fibromyalgia
  6. Joint pain and pain in bones: injuries, arthritis, laceration, periosteum or fractures.

Nociceptive Pain- Visceral

  1. Involves : interior organ trauma, injury or inflammation
  2. Ischemic : can be because of ulcers that are non healing, ischemic colitis, and myocardial infarction.
  3. Obstructions: these can be adhesions, strictures, and obstruction of kidney, bile duct, gallbladder, ureter and bladder.
  4. Inflammation and inadequate blood supply

Symptoms of  Chronic Nociceptive Pain

Nociceptive Pain

  • Constant
  • Reduced ligament or joint, muscle function
  • Moderate pain while taking rest
  • Aching quality
  • Well localized

Activities of Muscles, Joints or Ligaments

  • Pain can be intractable and severe
  • Pain that lasts for a limited time: healing of tissue resolves pain
  • Arthritis is an exception and isn’t time limited
  • Nociceptive Pain responds well to opioids and NSAIDs

Chronic Nociceptive pain- Treatment


  • Muscle Relaxants: Flexeril, Baclofen etc.,
  • Opioids : if there are certain side effects or not getting relief from NSAIDs, it can be used
  • Antibiotics: Right Antibiotics are used
  • NSAIDs : pain appears due to inflammation in tissues.

Manual Therapy for treating Chronic Nociceptive pain

  • Massage
  • Acupuncture
  • Physical therapy
  • Chiropractic treatment
  • Osteopathic manipulation for joints


  • Excision of gallbladder and appendix
  • Surgical procedure for treating fracture
  • Removal of skin lesions through abscess incision
  • Nerve Ablation
  • Epidural Injections

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