In memory of Cal Shearer
21st November 2024
A short journey through 'Pain'
16th Mar 2020
To celebrate Brain Awareness Week (BAW), 16-22 March 2020, we’re highlighting British Neuroscience Association’s (BNA) current 'Year of Pain'. With a short journey through ‘Pain’: an informative and fun mix of facts, research and quotations.
Chronic pain affects up to a half of adults in the UK.[1]
“It all begins when you are very young – pain in infancy and childhood affects pain sensitivity for the rest of your life” Professor Maria Fitzgerald, UCL
“We still don’t know exactly how the brain constructs this experience that you absolutely, unarguably know hurts.” Professor Irene Tracey[2]
First up, here's our TOP TEN of facts about Pain.
ONE
Pain is a necessary function, warning the body of potential or actual injury. It normally occurs when a nociceptive nerve terminal detects a damaging stimulus on the skin or in an internal organ. One of the ways in which pain signals are regulated within the nervous system is by the release of tiny quantities of neurotransmitter chemicals. Over one hundred types have been discovered.
TWO
But pain is not always directly related to injury. Widespread body pain such as fibromyalgia and migraine are common causes of pain where the mechanisms are still far from clear. This disconnect between injury and pain makes pain research especially interesting and challenging.
THREE
Pain is generally described as either acute or chronic. Acute pain commonly results from actual injury and damage to tissues and resolves when the injury is healed e.g a sprained ankle. Chronic pain lasts for months and years, becoming increasingly disconnected from injury, such as in arthritis.
FOUR
Neuropathic pain is a particularly unpleasant form of chronic pain that results from damage to the nerves. For example, sciatica, where a nerve is irritated or compressed in the lower spine, giving pain down the leg. It is resistant to most pain killers and is a subject of intense research.
FIVE
The major difference between acute and chronic pain is the role of the central nervous system. In chronic pain, tissue nociceptors become less important and networks in the spinal cord and brain begin to take over. This is why chronic pain is harder to treat than acute pain.
SIX
A feature of both acute and chronic pain is hypersensitivity, where even a touch or light pressure is painful. Recent advances in molecular genetics have identified specific groups of neurons in the spinal cord that act as pain ‘gates’: if these neurons stop functioning, the gate opens and pain sensitivity increases.
SEVEN
Even newborn infants can feel pain – but they may not feel it in the way that we do. Pain circuits in the brain and spinal cord mature slowly through childhood and are shaped by pain experience in early life. As a result, pain experience is individual to each person.
EIGHT
Our perception of pain critically depends on our emotional state. This can be related to the perceived cause of the pain, the feared consequences and our inability to alleviate pain.
Our mental state can aggravate pain but also has the potential to reduce it. Learning to understand our pain has therefore become a key method of treating chronic pain.
NINE
Fear can induce changes in pain perception. Pain (actual or anticipated) can induce fear of chronic pain. Chronic pain may alter cognition and emotion, leading to increased fear, anxiety, or depression.
TEN
The key pain relief medications can be split into four main categories: opioids (such as morphine), non-steroidal anti-inflammatory drugs (such as aspirin or ibuprofen) and paracetamol, which is not anti-inflammatory, antidepressants (such as amitriptyline), and gabapentinoids, which were originally discovered as anti-epileptic drugs.
"There is an enormous unmet need for novel drugs and devices to treat chronic pain, especially because awareness of the prescription opioid addiction crisis has belatedly led to a reduction in their prescribing for pain” Annette Dolphin, BNA President and Professor of Pharmacology, UCL.
DO YOU KNOW. . .?
Got a burning research question you want answering? Click on a selection of some of the most common questions below, via IASP ‘Relief’.
Do men and women experience pain differently?
Can the immune system influence chronic pain?
Why is pain not the same for everyone?
How do antidepressants ease pain?
What do we know about opioids and the brain?
Does what you eat affect chronic pain?
How does medical cannabis provide pain relief?
Some final words. . .
Only you feel your pain – which makes it a difficult experience to share accurately. . .but here are some famous attempts at doing just that. . .
“The greatest evil is physical pain.” Saint Augustine
“Of pain you could wish only one thing: that it should stop. Nothing in the world was so bad as physical pain. In the face of pain there are no heroes.” George Orwell, '1984'
“From the brain, and from the brain only arise our pleasures, joys, laughter and jests, as well as our sorrows, pains, griefs and tears.” Hippocrates
“The merest schoolgirl, when she falls in love, has Shakespeare or Keats to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.” Virginia Woolf
“Nature has placed mankind under the governance of two sovereign masters, pain and pleasure. It is for them alone to point out what we ought to do, as well as to determine what we shall do.” Jeremy Bentham, British philosopher & jurist
“I'm in pain all the time,' I said, 'and if I gave into it then I'd do nothing.” Bernard Cornwell, 'The Empty Throne'
“Most of the 'pain' we experience is of a perceptual order, perception either of the urge of unsatisfied instincts or of something in the external world which may be painful in itself or may arouse painful anticipations in the psychic apparatus and is recognised by it as 'danger.” Sigmund Freud, 'Beyond the Pleasure Principle'
BRAIN AWARENESS WEEK (BAW)
This year Brain Awareness Week takes place March 16-22, 2020. Celebrating its 25th-anniversary campaign, BAW is a global campaign, founded by The Dana Foundation, to engage and educate the public on the advances and advantages of brain research in a worldwide celebration of the brain!
Check out our calendar of events to find what’s happening near you UK-wide and Ireland.
Want to know more about pain research?
New treatments for pain: 14th May 2020. Free for members. Find out more here.
Some useful further info on ‘Pain’:
https://www.britishpainsociety.org/
https://www.painresearchforum.org/
https://www.practicalpainmanagement.com/pain/neuroscience-pain
[1] Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies, BMJ Journal [link here]
[2] https://www.newyorker.com/magazine/2018/07/02/the-neuroscience-of-pain