Chronic Primary Pain: is the diagnosis you give when pain is the main health problem, independent of any other underlying condition that could fully explain it. The pain is a disease in its own right. The mechanism driving this type of pain is primarily neuroplastic. Example: Fibromyalgia.

Chronic Secondary Pain: is the diagnosis given when the pain is an additional symptom of specific chronic medical condition. The pain is a secondary effect of an identifiable disease. The pain mechanisms involved are typically nociceptive or neuropathic.

Structural Chronic Pain (Nociceptive or Neuropathic): is caused by a specific, identifiable physical issue within the body. It is often diagnosed using imaging (like X-rays or MRIs), or through a physical examination. This can be acute (cut or a burn) or chronic.

Structural chronic type of damage in the body can either have nociceptive pain (ongoing long-term damage to the structure of the body like a tumor or inflammatory condition like RA) or it can be neuropathic, which is from damaged nerves or lesions in the nervous system).

Nociceptors are specialized nerve endings found throughout the body that act like the body’s alarm system. They detect potential harm—such as injury, pressure, or heat—and send signals to the brain, which interprets them as pain. All pain is an output that comes from the brain.

Non-Structural Chronic Pain (Neuroplastic): is not caused by an identifiable physical structural problem, injury, or disease that can be seen on imaging or through a standard physical exam. It often starts without any specific event, injury or disease, and persists gradually and insidiously. Sometimes there is a link between when the pain started and a major life stressor or traumatic event. Neuroplastic pain (also called nociplastic pain) is due to a malfunctioning of the pain system and is linked to the nervous system becoming heightened and overly sensitive.