To feel pain is a basic human experience that we all share. But for a clinical explanation of what pain is, there are no easy answers. We experience pain in so many ways that are very specific to the person experiencing it. What is pain? It depends on who you ask.
Lorimer Moseley is a clinical scientist specializing in investigating pain in humans and a member of the International Association for the Study of Pain. Says Moseley, the answer becomes a complicated one. “Some say pain is a warning signal that something is damaged,” he writes in a news article posted on the Study of Pain website. “But what about pain-free major trauma? Some say pain is the body’s way of telling you something is wrong, but what about phantom limb pain, where the painful body part is not even there? Some say it is an evil tormentor, relentless, brutal, and unforgiving; some say it is a reminder that they are broken, that their spine is ‘out’ or that their disc is ‘slipped.'” But discs never slip, he adds. “Others say it is punishment for their sins, or a test of their faithfulness.”
“Pain scientists are reasonably agreed that pain is an unpleasant feeling in our body that makes us want to stop and change our behavior,” Moseley notes. “We (scientists) now think of pain as a complex and highly sophisticated protective mechanism.”
As a martial artist, I have had many bouts with the onset of pain, enough to know that some athletes can develop an increasingly high threshold to reaching that point where it becomes intolerable. I have always believed that training and physical fitness has much to do with it. As pointed out in a Medical News Today report, “regular aerobic exercise, resistance training, and even circuit training may increase pain tolerance in otherwise healthy people.” The report adds that a study in the Journal of Rehabilitation Research and Development notes that “exercise increased markers for pain tolerance in people with chronic pain and post-traumatic stress disorder (PTSD).”
“To understand how pain emerges into consciousness will require us to understand how consciousness itself emerges, and that, the ‘hard problem,’ is proving to be very tricky indeed,” says Moseley. “The final consideration relates to chronic pain, the most burdensome health issue on the planet in terms of years lived with disability and economic cost to our societies.”
According to Johns Hopkins Medicine, there are two major types of pain modern medicine is most concerned with. Acute pain that may come from “inflammation, tissue damage, injury, illness, or recent surgery. It usually lasts less than a week or two. The pain usually ends after the underlying cause is treated or has been resolved.” Even more concerning is chronic pain that can persist for months or even years and “occurs along with a chronic health condition, such as arthritis. Chronic pain may be ‘on’ and ‘off’ or continuous. It may affect people to the point that they can’t work, eat properly, take part in physical activity, or enjoy life.”
As recently reported, a new study shows that people today are now developing chronic pain at higher rates than other common conditions. According to an NBC News report, “people are developing new cases of chronic pain at higher rates than new diagnoses of diabetes, depression or high blood pressure.”
In an annual survey conducted by the Centers for Disease Control and Prevention, and reported in the journal JAMA Network Open, adult participants were asked how often they experienced pain in the prior three months. For this exercise, chronic pain was defined as “pain on most days or every day during that window.” Since not everyone responded at the same intervals, the survey used a metric called “person-years,” which accounts for the number of people in the study and the amount of time between people’s survey responses.
The researchers identified “around 52 new cases of chronic pain per 1,000 person-years,” which was higher than the rate for high blood pressure (45 new cases per 1,000 person-years) and “far higher than the rates of new depression and diabetes cases.” According to the study, of those without any pain in 2019, 6.3% reported new chronic pain in 2020.
“What we’re finding is, to nobody’s surprise, we have an astounding problem of pre-existing chronic pain in this country and a huge amount of people who are developing chronic pain as each year goes by,” said Dr. Sean Mackey, chief of pain medicine at Stanford University School of Medicine. “Chronic pain can be a disease in and of its own right,” says Mackey. He added that people often experience chronic pain across multiple parts of the body, but low-back pain is the most common, followed by headache and neck pain.
But, for chronic pain sufferers, there may be some good news on the horizon. As reported by The Guardian, scientists have recently discovered an “objective biomarker” that is raising hope of finding a pathway for new treatments for people living with unmanageable pain.
According to the report published in Nature Neuroscience, “Brain signals that reveal how much pain a person is in have been discovered by scientists” who believe the work to be a step toward radical new treatments for people living with debilitating chronic pain. “It is the first-time researchers have decoded the brain activity underlying chronic pain in patients,” writes Guardian Science editor Ian Sample.
“What we’ve learned is that chronic pain can successfully be tracked and predicted in the real world, while patients are walking the dog, or at home, when they get up in the morning, and when they are going about their lives,” says Prasad Shirvalkar, a neurologist and lead researcher on the project at the University of California, San Francisco.
“But while chronic pain has fuelled a rise in prescriptions of powerful opioids, no medical treatments work well for the condition, prompting experts to call for a complete rethink in how health services handle patients with lasting pain,” says Sample.
“The hope is, as we understand this better, that we can use the information to develop personalised brain stimulation therapies for the most severe forms of pain,” says Shirvalkar.
