Chill by Mark Harper

Author:Mark Harper [Harper, Mark]
Language: eng
Format: epub
ISBN: 9781797213781
Publisher: Chronicle Books LLC
Published: 2022-06-01T03:00:00+00:00

Pain Is Simple, Pain Is Complex

I work from basic principles, and admittedly, I struggle to remember facts. However, I do remember one definition from my postgraduate exams, the one for pain: “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”

Pain is as simple as that. And not.

Everyone instinctively believes they understand the word pain. But when we stop to consider its meaning in full, it’s quite extraordinary how one short word can translate into such an incredibly complex concept. So complex, in fact, the International Association for the Study of Pain (IASP) spent two years revising—or, rather, expanding upon—the accepted definition of pain to include six key characteristics.

Our intuitive understanding of the word pain is, broadly speaking, what physiologists call “nociception,” the (relatively) straightforward process of a noxious stimulus causing a pain receptor to fire off a signal to the brain. The complexities arise because of the multilayered interpretation of that signal in the brain. This is why pain, according to the IASP, is always a personal experience influenced, to varying degrees, by specific biological, psychological, and social factors. Individuals learn the concept of pain through life experiences. Pain usually serves an effective and important adaptive role—its feedback is instrumental in how we learn to avoid danger. However, glitches in the multilayered interpretation system may set up abnormal circuits in the brain, which can have adverse effects on our ability to function and our social and psychological well-being.

The extent to which the perception of pain is not as simple as the stimulation of pain receptors sending signals to the brain becomes obvious when we consider all the different types of pain. We may first think of pain in terms of physical injury, such as cutting ourselves or stubbing a toe. So far, so simple.

But the sources of pain are many, and go well beyond obvious injuries: from broken bones to abdominal cramps, childbirth, period pains, tooth abscess, angina, arthritic joint pain, headache, a trapped nerve, high fever, and more. And what of the pain of a broken heart?

Then there are the different characteristics of pain: varying intensity, sharp, dull, constant, spasmodic, focused, diffuse, aching, burning.

Many things also influence the perception of pain. Quite apart from the obvious physical distinctions—most notably the location of an injury and the source or cause of it—there are genetics, our mood, the context (battlefield versus athletic field), our upbringing, cultural values, religious beliefs, previous experiences, and external reinforcement.

Pain can also be acute—such as when we stub a toe or immediately following an operation. Or chronic—such as when the initial stimulus is long gone and yet, years later, we are still suffering from its lingering effects. Acute pain is highly amenable to standard pharmacological interventions, that is, medicine. But chronic pain is thought to arise from the abnormal firing of neural circuits long after the adaptative function has passed.

When we consider all the different processes that underlie our subjective experience of pain, it becomes immediately apparent how incredibly diverse it is.

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