Center for Pain Management

Nocioceptive Pain

Would you describe your pain as aching, or throbbing? Is your pain mainly localized to your neck, mid or low back?

Receptors are specialized nerve cells in the body that fire in response to a particular stimulus. For example there are certain receptors that fire in response to pressure, cold, stretch, etc. The transmission of signals from these cells along nervous pathways ultimately to the brain allows the perception of the many sensations experienced within the human body. Nocioceptors are receptors that are sensitive to stimuli that can potentially or actually cause damage to body tissues. The perception of pain when these receptors are triggered by heat, trauma, pressure, inflammation, lack of oxygen etc. alerts the person that body tissues have been damaged or are in danger of being damaged. It is actually very dangerous for a rare group of people born without this ability to perceive pain because they are often unaware or injury or illness. Nocioceptive pain in the low back is the result of stimulation of these receptors within structures including muscles, ligaments, tendons, and the outer layers of the disc.

Examples of diagnoses involving nocioceptive pain in the low back include spondylosis (degenerative joint and /or disc disease), facet joint dysfunction, sacroiliac joint dysfunction, spondylolisthesis, myofascial pain (trigger points), compression fractures, sprains, and traumatic fractures.

These can be caused by trauma, acute injury, chronic postural stress, osteoarthritis, and autoimmune disease.

Assessment of these conditions often involves physician examination, imaging studies including x-ray, CT scan, MRI or bone scan; lab work, and diagnostic joint injection.

Nocioceptive pain of the low back often responds to injections into the involved areas including blocking the nerves that supply the facet joints, injections into the sacroiliac joints, and trigger point injections. Anti-inflammatory and muscle relaxant medications can be helpful and when appropriate this type of pain responds well to opioid medications. Physical therapists work with patients to decrease muscular pain, correct alignment, improve strength to decrease chronic muscle fatigue. Decreasing stress to the structures by correcting posture and improving body mechanics is also important.