What are the underlying causes of acute pain?

Acute pain, which typically lasts less than 3 months, plays a protective role in your body. Its purpose is to signal to your brain that you have an injury, or to warn you that you might be about to injure yourself.1 For example, when you touch something very hot, you automatically pull your hand away to prevent a burn.2 And when you already have an injury, pain is there to protect you and allow your body to heal by stopping you from doing things that will cause further damage.1 For example, experiencing pain during a workout may prompt you to stop exercising and seek medical help, as it might be something serious, like a fracture or tear.3

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What are the main underlying causes of chronic pain?

Chronic pain persists for a long time after you would expect the cause of acute pain to have resolved. There are three main underlying processes that are thought to be responsible for chronic pain in most people:1

Nociceptive pain

Caused by your genetics, environment, current emotional stresses

Neuropathic pain

Caused by nerve damage

Centralised pain

Caused by nerve damage, genetics, environment, emotional stress

Nociceptive pain

Nociceptive pain is pain that comes from injuries. It can either be somatic, which happens because of damage to your skin, muscles or bones, or visceral, which happens because of an injury to your internal organs.1

Neuropathic pain

Neuropathic pain is pain that comes from nerve damage. For example, this could be pain from a spinal cord injury, or pain that someone experiences after having a stroke.1

Centralised pain (also known as sensory hypersensitivity)

Centralised pain is pain that doesn’t seem to be coming from any tissue or nerve damage. It can be very difficult to pinpoint the cause of this kind of pain, and it is thought that factors like your genetics, environment, current emotional stresses and previous life events may contribute to how you experience this pain.1

Other processes involved in pain

Sometimes pain can be mixed, meaning that there are multiple different types going on at the same time. This can happen in people who have cancer or chronic pain conditions.1

It is also important to remember that pain can’t always be explained by physical processes. There can also be psychological and social factors that affect pain, and addressing these can really impact the way you respond to pain and the success of your treatment.2


  1. Stanos S, et al. Rethinking chronic pain in a primary care setting. Postgrad Med. 2016;128(5):502–15.
  2. Ju, W. Neuroscience: Canadian 1st Edition Open Textbook. Chapter 1.4.
  3. Cleveland Clinic. 8 Aches or Pains You Shouldn’t Ignore. Dec 2020. (Last accessed April 2023)

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