Ouch!

Richard Kaskiewicz

Pain is something that the vast majority of us will be subjected to on a daily basis. But what is pain exactly, how can we describe it or alleviate it? Why do we feel pain in the first place?

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The etymology of the word ‘pain’ can be traced back to many different places, but as for many things, we can probably thank ancient Greek or Latin. The world probably descends from the early Latin the word “poena”, which was used to describe punishment, and later changed to mean suffering or hardship. One apt definition would be that pain is a sensation that hurts. Then again, for you to define ‘hurts’, you need the concept of pain.

An interesting thing about pain is how we describe it, and the resulting subjectivity. Say you had to describe your pain to your friend, you might say something along the lines of, “a burning pain”, or “a piercing pain”; you’d have to use other words to describe the sensation. All of these are physical things that your friend may only understand to a certain degree. But what if the pain is emotional, how would you describe this? Imagine a doctor trying to treat your symptoms; they would need to know where your pain is as well as its severity, in order to prescribe appropriate, safe and beneficial treatments.

Thus, some methods of classification have been tried to be implemented, though to little avail, such as the dol unit, which was developed in the 1940s as a way to quantify pain inflicted on the human body. This idea was ultimately scrapped and never really applied, as one of the researchers stated “Everyone feels pain differently. Some people have conditions that should cause great pain, but don’t. Others have no sign of a physical problem, but are in great pain. Your level of chronic pain can’t be assessed in a scientific test or screening.”

To help overcome this, medical professionals now routinely categorise the harder-to-describe pains as acute or chronic. Acute pain is commonly associated with injury and is normally short lived, whereas chronic pain continues for a long time, or is reoccuring.

There are further complex medical terms within the two categories, but as they’re unknown to the layman, doctors often just ask them to rate their pain using pain assessment charts. These tend consist of 10 increasingly distressed faces, and the patient must chooses the one they empathise the most with.

This technique is also considered too subjective, but more promising research came from the University of Colorado in 2013. They used functional Magnetic Resonance Imaging (Real-time MRI scans) to quantify signals to the brain based on different levels of heat. This measured the effects on the brain directly, negating subjectivity and giving objective empirical measurements that could predict pain intensity with 95% accuracy.

This however, may not be useful for emotional pain, which unlike physical pain is actually caused by withdrawal symptoms. If the brain is no longer being flooded with the neurotransmitters, like dopamine and serotonin, that were making you happy beforehand, it craves them and compensates for the lack of the “feel good” hormones by creating more stress hormones like cortisol. This might explain why it took so long for you to get over your ex.

You may now be wondering why we feel pain in the first place. Pain is essentially your body signalling that something is wrong. The pain pathway starts with contact with a stimulus, which could be physical or chemical. These are recognised by nociceptors (pain receptors), which then relay signals through nerve cells to the central nervous system. This then sends signals to the brain warning of the danger and the damage occurring to the body. If the pain is too great and intense, though, your body may even bypass signalling to the brain first and allow you to react with reflex – such as moving your hand away from a hot stove.

People with defects in this pathway, commonly known as congenital analgesia, do not feel pain. Although this sounds great, it often causes premature death of the afflicted individual and debilitating injuries in early life. Children often bite through their tongue whilst still too young to understand their condition. Blindness is also common as they may get things in their eyes, like dust and glass, and not realise. Many sufferers end up injuring themselves severely and then continue to exacerbate damage, resulting in hospitalisation. The majority may also be unware that they are suffering from illness and the body may not respond effectively to remove invading pathogens, leading to more damage and a greater risk of death.

So, you may not like it, but pain may be the only reason you have got this far in life. So next time your body is telling you something is wrong, you may want to postpone the paracetamol and listen.

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