Nociceptors are specialised receptors that respond to actual or potential tissue threat — such as pressure, chemical irritation, temperature extremes, stretch, or reduced blood supply. Nociceptive pain is typically linked to tissue strain or injury and often improves as healing occurs. In persistent pain, nociceptive input can still play a role when joints, muscles, or other structures remain irritated or inflamed.

Neuropathic pain occurs when a nerve (or the spinal cord/brain) is affected by damage or disease. It is often described as burning, shooting, electric, or tingling, and may be associated with numbness or altered sensation. Neuropathic pain does not always respond well to simple painkillers and often needs targeted medication, rehabilitation, and treatment of the underlying cause where possible.

Nociplastic pain refers to pain arising from changes in how the nervous system processes and amplifies danger signals. The system becomes over-protective and produces pain even without ongoing tissue damage. This is common in long-standing pain conditions and is often improved through education, graded activity, sleep and stress regulation, and rehabilitation strategies that retrain the system over time.

Medication may be used to reduce pain and improve your ability to participate in other parts of your treatment plan, such as movement, rehabilitation, sleep, and lifestyle changes. Different medicines are used for different pain mechanisms and may include anti-inflammatory medicines, analgesics (pain relievers), and adjuvant medications that target nerve or pain-processing pathways. Your clinician should explain what the medication is for, how to take it safely, how long it is intended to be used, and what side effects or risks to watch for — and you should discuss any concerns or unexpected effects promptly.

Chronic pain is often best managed with an interdisciplinary rehabilitation approach that addresses function, movement, daily activity participation, and lifestyle contributors — not symptoms alone. At PAIN, rehabilitation may involve physiotherapy, occupational therapy, biokinetics, and dietetics, depending on your needs. These non-pharmacological interventions can support nociceptive, neuropathic, and nociplastic pain by improving strength, capacity, confidence in movement, pacing strategies, and overall health. When tailored and coordinated, rehabilitation becomes a key part of long-term self-management and better quality of life.

Pain procedures may be helpful for nociceptive pain and selected components of neuropathic pain, particularly when symptoms are linked to conditions such as osteoarthritis or inflammatory joint disease and conservative measures are not enough. These procedures do not treat the underlying condition itself; they aim to reduce pain so that you can participate more effectively in rehabilitation, movement, and self-management strategies. They are generally not effective for nociplastic pain, but in mixed pain presentations, reducing the nociceptive “volume” may create space to address sensitisation through other treatments. Effects are temporary and vary between individuals; some radiofrequency-based techniques can provide relief for months and, in selected cases, longer. Outcomes are best when procedures are part of a broader, individualised plan.

Surgery may be considered when there is a clear structural problem, progressive neurological compromise, spinal instability, or when appropriate conservative treatment has not achieved adequate control of symptoms. The decision is based on your history, examination, imaging, overall health, and functional goals — and includes a careful discussion of benefits, limitations, risks, and realistic recovery expectations. In many cases, surgery aims to address a specific anatomical issue (such as nerve compression or instability) rather than “cure” all pain. Rehabilitation and lifestyle strategies are often still important after surgery to optimise long-term outcomes. If surgical assessment is appropriate, your team can guide you and arrange referral to a suitably qualified specialist.

Dietitians support pain care by helping patients make practical, evidence-based nutrition choices that improve overall health and may reduce inflammation risk factors. Nutrition support can be especially helpful for weight management, metabolic health, gut symptoms, and energy levels — all of which can influence pain, recovery, and function. The aim is not perfection; it is a sustainable eating pattern that supports your condition and goals.

Persistent pain often leads to less movement, which can reduce strength and confidence and make pain more sensitive over time. Graded movement and exercise, introduced at the right level and progressed safely, can help restore capacity and reduce flare-ups. A rehabilitation team can help you pace activity, avoid boom-and-bust cycles, and build a plan that is realistic and safe for your diagnosis.

Pain rehabilitation is about improving function, independence, and quality of life — not just treating symptoms. Therapists help you build strategies for daily activities, confidence in movement, pacing, and long-term self-management. These skills remain useful beyond the current flare-up and form a foundation for durable improvement.