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The Gift of Acute Pain

Life depends on possessing protective sensation

Key points

  • Acute nocioceptive pain is basic to our evolution and survival. The term refers specifically to physical input.
  • Acute and chronic mental pain are completely separate matters. Chronic pain has no survival value.
  • Without protective sensation, every organ system will eventually break down.

Mental/emotional pain is processed in similar regions of the brain as physical pain, and both stimulate a flight-or-fight response. Nocioceptive pain refers only to the physical component of pain sensation and what most people consider to be the main issue in causing their suffering. It is not. Mental pain is a much greater problem.

Acute nocioceptive pain is a necessary protective response; we cannot survive without it. That distinguishes it from chronic pain, which does not have a useful function—especially chronic emotional pain.

The brain is the central processing unit

Your brain is constantly analyzing whether various sensory inputs are pleasant, neutral, or unsafe. Pain or discomfort can exist only after your brain interprets an external stimulus. Consider the following sensations:

  • Too hot or cold
  • Crushing pressure
  • Distended stomach or bladder
  • Sharp
  • Blinding
  • Too loud
  • Bitter taste
  • Rotten odor

The list is endless, but at a certain cumulative threshold, your body senses that there is a threat and activates a fight-or-flight response. The word humans use to characterize this feeling is “anxiety.” The sensation is intended to be so unpleasant that you are compelled to take conscious or unconscious action to resolve the threat. This is how all living creatures, including humans, evolved and continue to stay alive. Anxiety is the result of a threat and not the cause. It is an unconscious automatic physiological response and not a psychological one.

Your brain as a linkage system

The brain works by association, so pain quickly becomes connected to the situation that caused it. We learn what to do to avoid danger, and then we do the same thing each time we re-encounter that danger. It takes only one time for us to put a hand too close to the flame, feel the heat, and realize it can burn us to keep us from ever doing it again.

Carolyn Franks/AdobeStock
Source: Carolyn Franks/AdobeStock

The nervous system works as a unit and includes the brain, mid-brain (autonomic nervous system), spinal cord, peripheral nerves, and various types of receptors. Each type of warning signal is sent by a specific receptor. However, the brain must interpret the intensity, duration, and other inputs before it decides whether it is dangerous or safe. There is nothing in these receptors that creates pain signals without it being processed by your central nervous system.

One excellent example comes from a research paper that measured the pain threshold when a cold probe (not damaging) was placed on volunteers' forearms. They were able to endure more pain when they were looking at a blue light compared to seeing a red light.1 All inputs contribute to the final interpretation of danger.

The nocioceptive system

There is not one area in the brain that is responsible for feeling pain. Remember, that you brain must continually compare the present to your past, where threat versus safety was learned. The set of neurological circuits that works on interpreting physical sensory input is called the nocioceptive system, which automatically guides our behavior to avoid pain and remain safe.

Although you probably don’t realize it, when you are sitting on a chair, your body is constantly shifting to avoid damaging your skin. This protective mechanism does not exist in people who are completely paralyzed, and , as a result, pressure sores may occur. You don’t consciously have to decide to not touch a hot burner on the stove.

Most of the time, we are not aware of the incredible benefits of our pain-avoidance system. So if we experience unpleasant sensations, we have exceeded the limits and the sensations are sent up to higher brain centers to make a conscious decision. Consider a marathon runner who has “hit the wall” and doesn’t feel he or she can go another step. The body is screaming “danger.” It is not that they do not feel discomfort—they have consciously decided to override the warning.

Acute pain is a gift

Acute pain is the physical link to the environment that specifically protects each of your body parts, and it is necessary for survival. Every cell in your body has a structural limit. If you stare directly into the sun, you will go blind. If you repetitively listen to extremely loud music, you’ll experience hearing loss. Every joint has a weight limit and will be destroyed if it is consistently exceeded.

People without protective sensations eventually experience joint destruction that often becomes a “bag of bones.” The resulting deformities are severe and crippling. It is most common in diabetics suffering from peripheral neuropathy and patients with leprosy. The survival for those born without pain receptors, a condition called congenital indifference to pain, is about twelve to fifteen years. Parents can do nothing to teach these children how to protect themselves.2

Every attempt to replicate the nocioceptive system for those who lack a protective pain system has failed miserably. This system is a wonderfully balanced and intricate gift when it functions well and the worst part of human existence when it has gone awry.3

Watchara/AdobeStock
Source: Watchara/AdobeStock

Chronic pain is a curse. It is not part of the nocioceptive system and is a neurological disorder that affects your body’s chemical makeup (physiology). It is important to consider acute pain and chronic pain as separate entities.

It's important to note that surgical procedures are effective only for nocioceptive pain from an identifiable anatomical abnormality.

References

1. Moseley GL and A Arntz. The context of a noxious stimulus affects the pain it evokes. Pain (2007); 133:64-71. doi: 1016/j.pain.2007.03.002

2. Yancey, P and Paul Brand. Pain: The Gift Nobody Wants. DIANE Publishing Company (1999).

3. Baliki MN and A Vania Apkarian. “Nociception, pain, negative moods, and behavior selection.” Neuron (2015); 87: 474-491.

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