A pain in the…

Regions of the cerebral cortex associated with...

Regions of the cerebral cortex associated with pain. (Photo credit: Wikipedia)

Everyone has experienced pain at some time, even it is caused by a simple knock or scratch. Many people have  experienced pain over the whole range from mild to excruciating. Of course it is impossible to know what another is experiencing so we compare pains by saying that a pain is like, for example, toothache, or that it is a stabbing pain.

We still don’t know exactly what others feel. As JLS sings “Do you feel what I feel?”. But we might have some idea, by comparison with our own experience. Another way that doctors use is to ask the patient to rate the pain on a scale of 1 to ten. as in this case the doctors can usually assess the type of pain. But they will sometimes ask if the pain is stabbing, pricking, aching, or whatever.

There is no doubt that pain, real pain, is an intense feeling. but our memories of pain that we have experienced seem curiously muted. If you think back to a time when you were injured, however, you will probably not be able to exactly how intense the experience was. I recall from somewhere that a mother, reflecting on the whole process of child-bearing said of the pain that if mothers could remember how it felt to give birth then it would be unlikely that there would be any second or third babies in a family.

Just as one remembers some life events and forgets others, seemingly at random, we may remember some injuries and forget others. I remember vividly scraping my skin on a rock which resulted in a nice scar, but I don’t remember the pain that I must have suffered when I received another scar, on my hand this time. It could of course simply be that the second injury happened decades before the first, and the memory of the pain may have simply faded. I think that there is more to it than that, though I don’t know what, exactly.

When a predator brings down its prey, say a lion captures a gazelle, it may often start to feed on the prey even though it might not yet be completely dead. This seems to us, today, to be cruel, but some people say that the prey doesn’t experience the pain as its brain switches off the pain and its consciousness, as a result of the shock. I’m not sure that this isn’t wishful thinking with nature thereby being thought of as “being kind” to the prey.

I put the scare quotes in there because it is gross anthropomorphism to say that. Nature is neither kind nor cruel. Also, on the rare occasion that a prey animal is accidentally freed by the predator, the prey will immediately try to escape, which it would not if it were stunned by the shock of its capture.

Nevertheless, there is something in the idea. People who have been stabbed or shot sometimes say that they thought that someone has hit them and that they were unaware that they had been stabbed or shot. This could be for a number of reasons. The nerves that affected by such puncturing wounds pain are mainly located on the surface of the skin, and a projectile or blade may affect only a few of them. When a person notices that they have been stabbed, they may suddenly experience the pain.

My experience backs this up. I have found that even a quite deep cut may not hurt until you notice it. A burn, however, is usually felt very quickly. In fact the body’s response to a burn is an almost immediate recoil.

Burn icon

Burn icon (Photo credit: Wikipedia)

Some pain, organ or visceral pain, happens deep inside the body. It’s the pain of appendicitis for example, or of gall bladder disease to name just two examples out of many. It may be difficult to tell which organ is affected as the pain may seem to be located in a different location from the affected organ. For instance in appendicitis the pain may start towards the middle of the abdomen rather than at the side where the appendix is located.

A different category of pain is mental pain. This is distinct from physical pain, though the two types may be linked as pain can affect the emotions, either directly through the autonomic nervous system, or indirectly through the sufferer’s physical restrictions caused by the pain, such as frustration, anxiety and other symptoms.

Mental pain is often likened to physical pain, as when grief is described in terms of physical pain and other symptoms. To someone who has suddenly been bereaved it often seems very much like a physical blow, and physical effects such as weight loss, nausea, sweating and feeling cold are all possible. I believe that mental pain can be as deeply felt as physical pain.

While we have pain killers for physical pain which can be targeted at specific symptoms and even organs, treatments for mental pain seem to me to be primitive in comparison. I need to add a disclaimer here, as I am not a medical practitioner nor have I experienced grief or other deep mental pain, so I simply do not know for sure if what I said above is true.

I do know that treatment for depression, which I suffer from now and then, appears to be effective, but there appear to be as many treatment and drugs as there are people suffering from the disease. Again, this is my non-medical view and I may be unaware of why there seem to be so many treatments for one condition. There may be reasons.

One other thing from my random stroll through the topic of pain – we seem to be able to feel things outside of our bodies. Amputees often report feeling itching and pain in their removed limbs or parts of limbs. This is known as “phantom pain“, and strangely it can be helped by superimposing an image of the patient’s intact limb over the absent or partial limb.

English: SAN DIEGO (June 13, 2011) Lynn Boulan...

English: SAN DIEGO (June 13, 2011) Lynn Boulanger, an occupational therapy assistant and certified hand therapist, uses mirror therapy to help address phantom pain for Marine Cpl. Anthony McDaniel. The Occupational Therapy department provides patients with rehabilitation services to heal and restore service members to their highest level of everyday functional outcomes. (U.S. Navy photo by Mass Communication Specialist Seaman Joseph A. Boomhower/Released) (Photo credit: Wikipedia)

The phantom limb pain obviously arises in the mind and the mirror trick fools the mind somehow into thinking that the limb is intact again. Of course, all pain is, fundamentally, in the mind, but apparently the mind can be fooled into firstly creating the phantom pain and secondly, into forgetting it, even though the patient knows that the limb has been damaged.

The reason for pain seems obvious – the body (or mind) is damaged in some way, and the pain is a signal that something needs to be done. But this simplistic answer doesn’t cover a lot of cases – the phantom pain of an amputated limb, for example. Nothing can be done about such pain, so why do we feel it? I think that I need to do some reading!

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