There is more to pain than just injury

There is more to pain than just injury

Many people think that pain is the result of injury or damage to tissue. The reason for that is that pain warns us whenever we're experiencing tissue damage or are about to.

But there is more to pain. Our perception of pain is constructed from sensory information and context - our circumstance, needs, motivations, who we're with, and our expectations. This means that pain is more malleable and manageable than we think.

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sciencefocus.com

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Placebo can be a powerful treatment as it can cause pain relief or therapeutic benefit on the expectation of treatment rather than 'real' treatment.

  • Studies show patients expecting morphine increase the circulation of their own endogenous opioids in advance of getting morphine.
  • Patients who had undergone amputation can overcome phantom limb pain with mirror therapy. The brain is tricked into thinking their limb is restored and able to move, loosening up the discomfort.

Pain is an indicator of injury, but not always. Some things like sunburn initially don't hurt. It only starts to hurt when our skin cells begin to die.

A more dramatic example is radiation exposure. It doesn't hurt while a person is exposed because they can only feel what the sensory nervous system can sense. But later on, the radiation poisoning may cause severe damage to the skin and soft tissue.

Nociception is often a part of the experience of pain, but it is not pain. It is not sufficient nor necessary for pain, for example, when we consider the pain of depression or grief.

So tissue damage can happen without pain, and pain can occur without tissue damage, and nociception that seems like pain isn't pain. This is because our experience of our bodies, perceptions, and explanations of the perceptions is part of a complex network of our nervous system.

Our complex nervous systems continually process and integrate information about the body, regulating and balancing the resources. We respond and adapt to what is happening to us or is expected to happen to us.

We do this by running simulations of information we gathered and stored from past experiences. We can feel the signals of these simulations just as intensely as the signals we get from actual injury. This can be useful as the body can kickstart the circulation of our endogenous painkillers just before the injury happens.

If we received a real injury, it wouldn't disappear because we use the power of positive thinking. Paracetamol does work for pain, and surgical and pharmacological interventions are life-saving and can reduce suffering.

But pain is complex. It is often caused more by what we think and fear, and that means we have more tools at our disposal to deal with it.

Activity in the neurons that responds to injury is called nociception. It allows us to recognise and label different kinds of damaging stimuli, such as slamming your hand in the door or burning it on a stove.

Researchers wanted to observe what happens in the brain when we're exposed to damaging stimuli. They reported a pattern of neural activation across a network of brain regions that tracked nociceptive activity. Surprisingly, neuroscientists also observed this signature in the brain, and patients can report intense pain, without any tissue damage.

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RELATED IDEAS

Pain: The Unwanted Discomfort
  • Pain, whether emotional or physical is practically unavoidable in the entire human existence. Drugs may blunt it to an extent (with severe side-effects), but we all dread pain and wish it wasn’t there in our lives.
  • Pain is, at its core, a flashing red light on the cockpit, a warning system of the human body, guiding it on what action, reflexive or respondatory, has to be taken.
  • Acute pain, like when you burn your hand on the stove, is essential to our survival and is something all living species(some say even plants) have in common.
Pain: A Complex Phenomenon
  • We all have experienced pain, be it physical or psychological.
  • Trying to quantify or define the intensity of the hurt being experienced isn’t easy.
  • Pain is relative, as each of us has a different anatomical and neurochemical build, a different context that makes it unique.
  • All these factors make pain a complex phenomenon, and most of us are managing it pharmacologically (popping pills), which generally causes problems.
5 Brain myths debunked
  1. We use only 10% of our brains. PET or fMRI scans show that much of the brain is engaged even during simple tasks. But there's also the fact that highly motivated people score higher on IQ tests, which suggests that we don’t always exercise our minds at 💯% capacity.
  2. “Flashbulb memories” are precise, detailed and persistent. Memories that feel as vivid and accurate as a 📸, remember exactly where we were, what we were doing, who we were with, what we saw or heard. But the memories decay over time and without being aware of it, we forget important details and add incorrect ones.
  3. It’s all downhill after 40 (or 50 or 60 or 70). Plenty of mental skills improve with age. Like vocabulary, tests of social wisdom, regulating emotions and finding meaning in life.
  4. We have five senses. Sight, smell, 👂🏼, taste and touch are the big ones. But we also have proprioception, nociception, sense of balance, sense of body temperature, acceleration and the passage of time.
  5. Brains are like computers. The brain doesn’t have a set memory capacity, doesn’t compute the way a 💻 does, & even basic visual perception isn’t passive inputs because we actively interpret, anticipate & pay attention to different elements of the visual world.

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