We Don’t Know: Pain

We Don’t Know: Pain

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Pain. We know it when we feel it. Not just because it hurts… [scream] But because it’s so subjective and hard to quantify. What do do doctors rely on as the gold standard to evaluate pain in 2016? Self assessment. That’s right, a chart that goes from happy face 0 to sobbing face 10. Not exactly precise. So, why can’t we just plug someone into a machine and get an objective readout of how much pain they’re in? Pain is complicated and there’s still a lot we don’t know about it. Here’s what we do know: It helps us react quickly if we’re in danger and alerts us to injury and illness. There might even be a good kind of pain… I feel like you know no pain no gain, the saying rings true for, you know, working out and like I guess trying to achieve a goal. You know, studying hard for a test. Popping a zit? Yeah, a masseuse, that’s a good pain. I’m like: “Rub that tension away.” We can’t talk about that on film [laughs]. We do mostly understand the biochemistry of how pain signals get sent to the brain. We can design drugs that target that chemistry to ease pain, but we haven’t found a way to look at those signals to measure it. Some mutations in our genes lead to pain disorders like not being able to feel pain or feeling excessive amounts. But more often, genes and the environment we live in both contribute to whether we experience some sort of pain disease, like arthritis. So, pain starts out as a signal registered
by sensors in the body. But once the signals get to the brain, our expectations can affect how strongly we feel that pain. Rather than simply passing the signal along, our higher brain functions meddle in what we end up feeling. A group of areas in the brain, called the “pain matrix,” will light up in an MRI scan when an individual is feeling pain. But, recent research shows that the pain matrix can be misleading. Using a group of patients who never feel pain, a study found that their pain matrix still activates in response to stimuli that healthy people find painful. What the pain matrix actually responds to is any kind of threat, whether it’s painful or not. Researchers are now pursuing what they call the “neurological pain signature”. They’re counting on high-resolution scanning techniques to show what specific parts of the pain matrix are involved in feeling actual pain. They also want to learn how the brain separates immediate pain from chronic pain. Scientists are hoping that someday they will have a pattern of brain activation that corresponds exactly to pain. Our brains will always make pain a unique experience for each of us. But perhaps in the future, our understanding of pain can be more precise than sobbing face 10. On the pain scale, where do you think the worst pain you’ve ever felt, falls? I say zero, but I know have a high tolerance for pain. 10, child birth, without any medication. I’ve always wondered how does my sense of pain compare to other people’s sense of pain. And that would kind of, if they could say this hurts as much as breaking my leg. Eight pounds.

4 thoughts on “We Don’t Know: Pain”

  1. When you're treating pain, subjective scores for pain are useful and NOT quantified pain. The overall pain sensation each individual person experiences is what you should treat and not some objective scores. Each individual has a unique pain tolerance. As long as the pain is well tolerated you don't need to treat it with pain killers. This will lead to over and under treating pain issues patients.

    Subjective pain analysis is the way to go.

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