Is there a name for this sensation?

[Jimmy Snyder]

I suffer terribly from kidney stones and have had episodes of excruciating pain associated with them. These episodes can last for hours. I recently had an ultrasound lithotripsy which is a procedure to break up stones in the kidney using sound waves. As a result I have been passing fragments of stone that are too small to cause pain or even any sensation whatever. However, two of the larger fragments passed with a sensation that is like pain. I wonder if there is a medical term for what I experienced. That is, the exact same sensation, the same nerves, the same mental construction as the most excruciating stone pain. The similarity to stone pain is undeniable. Yet it is so subtle as to be just above the threshold of sensation and duration less than a second. Pain doesn't seem to be the right word to express a sensation that isn't painful at all.

 

[DanP]

I suffer terribly from kidney stones and have had episodes of excruciating pain associated with them. These episodes can last for hours. I recently had an ultrasound lithotripsy which is a procedure to break up stones in the kidney using sound waves. As a result I have been passing fragments of stone that are too small to cause pain or even any sensation whatever. However, two of the larger fragments passed with a sensation that is like pain. I wonder if there is a medical term for what I experienced. That is, the exact same sensation, the same nerves, the same mental construction as the most excruciating stone pain. The similarity to stone pain is undeniable. Yet it is so subtle as to be just above the threshold of sensation and duration less than a second. Pain doesn't seem to be the right word to express a sensation that isn't painful at all.

Its still pain.

 

[Pythagorean]

look into "first pain" vs. "second pain"

It almost sounds to me as if you're only experiencing second pain.

 

[hypatia]

Jimmy, I think the problem here is that everyone is reading this, cringing ..perhaps even shuttering, then slowly backing out of the thread. That kind of pain is unreal.

 

[lisab]

I *may* have felt that before, though not in connection with kidney stones (thankfully!). Is it the same sensation you get when ice touches your skin for just a moment? For example, wet ice that touches the inner arm. That sensation is closer to pain than cold, but really it's neither, to me at least.

 

[Proton Soup]

i think it's called heebie jeebies

 

[Jimmy Snyder]

look into "first pain" vs. "second pain"

It almost sounds to me as if you're only experiencing second pain.

I did so. The first site I looked at had extensive definitions of these terms and some others as well. In fact it seemed to be about defining terms. I don't agree that the difference between first pain and second pain is what I am talking about. However, I wrote an email to the author of the article with pretty much the same text as the OP. The response I got back was that she wasn't into defining terms (?) she also wrote this:

Speaking generally, I think that pain is a spectrum from the intense pain of kidney stones (perhaps one of the most intense pains known to man) to the subtle 'sensation' you describe.

In other words the term she suggests is 'pain'. I hate it when my urologist asks if I am experiencing pain. If I say yes, I have to explain and if I say no I still have to explain. I wish I could say "I'm feeling _____" and have him understand. I'm going to look for another site on first-second pain and try again.

 

[DanP]

In other words the term she suggests is 'pain'. I hate it when my urologist asks if I am experiencing pain. If I say yes, I have to explain and if I say no I still have to explain. I wish I could say "I'm feeling _____" and have him understand. I'm going to look for another site on first-second pain and try again.

Paralysis by analysis. Just say you are experiencing very low intensity pain.

 

[hypatia]

Could it be a pain memory response? They know that increased excitability of pain receptors in the brain actually remember the pain. It produces an increased sensitivity that can last for many months. So it can hurt, while not really hurting.

 

[Dadface]

Could it be defined as a "transient" or "ephemeral"pain or something similar? it seems that the stimuli are not severe enough to cause any lasting discomfort and are momentary in that they disappear as the stone fragments are passed.

 

[Pythagorean]

I did so. The first site I looked at had extensive definitions of these terms and some others as well. In fact it seemed to be about defining terms. I don't agree that the difference between first pain and second pain is what I am talking about. However, I wrote an email to the author of the article with pretty much the same text as the OP. The response I got back was that she wasn't into defining terms (?) she also wrote this:



In other words the term she suggests is 'pain'. I hate it when my urologist asks if I am experiencing pain. If I say yes, I have to explain and if I say no I still have to explain. I wish I could say "I'm feeling _____" and have him understand. I'm going to look for another site on first-second pain and try again.

1st pain is the initial sharp, shocking part.

2nd pain is the slower, duller, glowy (sometimes warm) pain.

It is a unique perceptual phenomenon that single painful stimuli yield two successive and qualitatively distinct sensations referred to as first and second pain sensation (1–4). First pain is brief, pricking, and well localized, whereas second pain is longer-lasting, burning, and less well localized. Peripherally, the neural basis of this phenomenon is a dual pathway for pain with Aδ and C fibers mediating first and second pain, respectively (2, 3). Different conduction velocities of both fiber types of about 10–20 and 1 m/s (5, 6) account for the temporal sequence of both sensations with reaction times to first pain of 400–500 ms and to second pain of about 1,000 ms after application of painful stimuli to the hand (1, 2, 4, 7).

http://www.pnas.org/content/99/19/12444.full

 

[Jimmy Snyder]

The thing is, there is no difference in the two sensations other than the intensity and duration. There is no difference in burning/pricking or in localization. That's why I don't think the first/second pain difference will apply. Also, the two sensations do not occur in conjunction with each other. I haven't experienced intense stone pain for many months now. However, the milder form has come about 5 times in the past two weeks.

 

[DanP]

The thing is, there is no difference in the two sensations other than the intensity and duration. There is no difference in burning/pricking or in localization. That's why I don't think the first/second pain difference will apply. Also, the two sensations do not occur in conjunction with each other. I haven't experienced intense stone pain for many months now. However, the milder form has come about 5 times in the past two weeks.

pain ?

 

[Pythagorean]

First/second pain isn't so simple except for in the case of acute pain. First pain pathways are unique to pain, but 2nd pain pathways are not.

Both 1st and 2nd pain can result from acute (injuries) but 2nd pain can come from temperature sensations (the fuzzy boundary between too hot or cold and not too hot or cold) and vibrations, or gradual stretching of skin)

It's also possible you're experiencing non-nociceptive pain (what used to be considered imagined, but have been found to have neurological basis in cases like phantom limbs).

Also completely possible that as Dan suggests, you're experiencing a very low intensity acute pain from passing the stone.

 

[nismaratwork]

It's called: Visceral Pain.

In your case, it's brief, but it's still visceral pain.

 

[Jimmy Snyder]

It's called: Visceral Pain.

In your case, it's brief, but it's still visceral pain.

The intense pain and the subtle pain are both visceral pain. What I'm looking for is the term that differentiates between the two intensities.

 

[nismaratwork]

The intense pain and the subtle pain are both visceral pain. What I'm looking for is the term that differentiates between the two intensities.

You're going to hate this, but... see Pythagorean's posts. Truly, there just isn't commonly used formal terms for what you're experiencing beyond theories; pain is still a frontier.

So... good question, but no answer except, "transient visceral pain", or, "*fiber priming".

 

[calliope]

I think I have had similar sensations, that is both excruciating and benign sensations apparently originating in the same pain pathways (burns, ovarian, teeth etc.).

I call the benign ones "twinges."

 

[rhody]

Jimmy,

I had to jump in and may be wrong, but after reading a bunch of background on pain, what about this: http://www.medicinenet.com/neuropathic_pain/article.htm"

Neuropathic pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.

One example of neuropathic pain is called phantom limb syndrome. This occurs when an arm or a leg has been removed because of illness or injury, but the brain still gets pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.

You told me that the ureter that passed a large stone had been "dilated" somewhat, and if that occurred I would imagine some damage to the nerves in the area(s) of the expansion may have occurred.

I have also read this type of pain as referred to as: http://en.wikipedia.org/wiki/Peripheral_neuropathy" or peripheral neuropathy.

Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system,[1] which may be caused either by diseases of or trauma to the nerve or the side-effects of systemic illness.

Something else to consider: the type of nerve or nerves involved in the ureter area:

Symptoms depend on the type of nerves affected (motor, sensory, or autonomic) and where the nerves are located in the body. One or more types of nerves may be affected. Common symptoms associated with damage to the motor nerve are muscle weakness, cramps, and spasms. Loss of balance and coordination may also occur. Damage to the sensory nerve can produce tingling, numbness, and pain. Pain associated with this nerve is described in various ways such as the following: sensation of wearing an invisible "glove" or "sock", burning, freezing, or electric-like, extreme sensitivity to touch.

After reading this and your description of the pain, it seems to indicate a sensory nerve, but a neurologist could pin it down with more detail and accuracy. Just my two cents worth...

Rhody...

P.S. I am glad to hear the excruciating pain is not a problem, minor pain is a nuisance and can be tolerated.

 

[nismaratwork]

Jimmy,

I had to jump in and may be wrong, but after reading a bunch of background on pain, what about this: http://www.medicinenet.com/neuropathic_pain/article.htm"

You told me that the ureter that passed a large stone had been "dilated" somewhat, and if that occurred I would imagine some damage to the nerves in the area(s) of the expansion may have occurred.

I have also read this type of pain as referred to as: http://en.wikipedia.org/wiki/Peripheral_neuropathy" or peripheral neuropathy.

Something else to consider: the type of nerve or nerves involved in the ureter area:


After reading this and your description of the pain, it seems to indicate a sensory nerve, but a neurologist could pin it down with more detail and accuracy. Just my two cents worth...

Rhody...

P.S. I am glad to hear the excruciating pain is not a problem, minor pain is a nuisance and can be tolerated.

Your view would be strong support for Pythagorean's case, and the notion of primed *fibers. I find it very convincing... when someone says, "no, it's not what you said"... I listen. If it's not visceral pain, then this strikes me (IMO) as likely.

 

[Pythagorean]

Group C nerve fibers

 

[Jimmy Snyder]

Twinge is the best so far, but it doesn't really hit the spot. Twinge of what? It isn't really pain because it isn't painful. But it is very like pain because it follows the exact same physical and mental pathways as real pain. There's no question that it is visceral pain. That just means that the pain originates in the internal organs. As for some of the other suggestions, I should note that there is a very strong correlation between these twinges and the production of not large, but relatively large stones. That is, I pass a lot of sand these days, diameter less than 1 mm. However, after such a twinge I am sure to produce a stone of about 1.5 mm in the next 6 to 12 hours. So far I'm 5 for 5 on that score.

 

[DanP]

Twinge is the best so far, but it doesn't really hit the spot. Twinge of what? It isn't really pain because it isn't painful. But it is very like pain because it follows the exact same physical and mental pathways as real pain. There's no question that it is visceral pain. That just means that the pain originates in the internal organs. As for some of the other suggestions, I should note that there is a very strong correlation between these twinges and the production of not large, but relatively large stones. That is, I pass a lot of sand these days, diameter less than 1 mm. However, after such a twinge I am sure to produce a stone of about 1.5 mm in the next 6 to 12 hours. So far I'm 5 for 5 on that score.

Pain intensity lies on a continuum scale man. A pain just about the threshold will be very mild, it won't cause serious discomfort, but that is still called pain. What you feel is pain.

 

[nismaratwork]

"Teen Spirit."