New Ideas About Pain

How We Understand Pain

Previous theories about pain are being challenged by new technology and research.

The previous idea about pain involved terms like: “pain receptors”, “pain nerves” or “pain pathways”.

The idea was that there were nerves all throughout our bodies and, when one of these was stressed or triggered, a message of pain was sent to the brain.  This idea always had some problems because it could not explain certain occurrences.

For example, we know that the amount of pain we experience does not necessarily relate to the amount of tissue damage.  Then there is the phenomenon of phantom limb pain, where a body part gets severed from the body, but the person still experiences pain in the absent body part.  And, of course, people with chronic pain grow tired of hearing that all the tests indicate there is nothing physically wrong, but yet they continue to experience pain.  There are numerous other examples, but I think you get the idea.

New technology allows for the examination of the various “sensors” that are in the walls of neurons (i.e., nerves) that convey information toward the spinal cord.

These sensors are specialized to respond to mechanical changes, temperature changes, chemical changes, etc.

There are some neurons that respond to all manner of stimulation, if that stimulation is sufficient to be potentially dangerous to tissue.

Activation of these special neurons sends a prioritized “alarm” signal to your spinal cord, which may or may not be sent on to your brain.  This type of activity has been labeled “nocioception” which literally means “danger reception”.   When a nocioception signal reaches the brain, it is analyzed against other information available to the brain.  If/when the brain evaluates that there is danger to the body, the brain sets off an alarm signal.  This alarm signal is known as pain.

How We Can Address Pain Signals

In summary, it now seems apparent that the signals sent to the spinal cord are not pain signals, they are potential danger signals.

Only when the signal reaches the brain, and is interpreted by the brain to constitute a real and present danger is pain activated.  Viewed in this way, there are several levels to address pain.

You can find a way to stop the activation of the danger signal if possible (i.e., alleviate the mechanical, temperature or chemical forces that activated the danger signal); find a way to keep the danger signals from reaching the brain (e.g., this is how a spinal cord stimulator works); find ways to keep the brain from sounding the pain alarm at all, or at least lower the intensity of the alarm.

This latter level of intervention has led to the notion of:  “To treat your pain, you need to treat your brain”.

There are various ways of doing this, ranging from medications that alter the firing of the pain pathways, to psychological interventions that decrease the focus on the pain thereby lessening the experienced intensity, to EEG biofeedback which actually seeks to calm the firing of the brain pathways that are involved in the alarm signal.  There will be more on these methods in a future submission.

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