Your Brain and Pain

Our last blog post regarding pain brings us to a discussion about the brain.  After all, it does control our perceptions of pain, so any discussion about the topic needs to include a discussion about the brain.  *Warning!  Science-y words and concepts ahead!* I’ll try to keep it as simple as possible, but the truth is that researchers don’t fully understand the brain’s functions in pain perception and all of its twists and turns.  Some of these twists and turns are complicated.  Let’s start by revisiting the definition of pain. 

                “Pain is an unpleasant sensory and emotional experience that is associated with actual or potential tissue damage.”  Pain is an experience unique to each person.  We all have different pain tolerances.  Some of us can have blood drawn – no problem.  Not an issue.  Others of us can’t do it without the building expectation of something painful – that pinprick becomes a knife. 

While the intensity of pain varies from person to person, the basic biochemical and neurological processes that create the perception of pain is the same in every individual.  It’s a two-step progression that starts with a biochemical process involving nociceptors, special sensors all over our bodies that detect stimuli.  We’ll use that pinprick as our stimulus.  The needle is pushed into your arm.  The nociceptors in your arm immediately start firing signals that travel up the spinal cord and to the brain.  The neurons and glia in the brain process the signals.  This pathway is our somatosensory pathway and it ends in the cerebral cortex of the brain.  The speed and intensity of these pain signals depends on the level of pain or trauma being sensed by the nociceptors.  A network in the brain called the salience system decides whether you should stop the pinprick or whether you should carry on.  Step 2 is the neurological process, the perception of pain, and this is where it can get a little tricky.  This is where some of us shrug it off and some of us stop everything and pay attention to the pain.  Since there could be serious consequences to pain, the salience network is activated by the pain signal.  You immediately pay attention to the pain and other signals along the motor pathways force you to draw away, but most of us won’t draw away from the needle.  Most of us won’t pull our arms back.  We have the ability to overcome these signals.  We have the ability to “work through the pain”.

Once the pain signal is in the brain, the thalamus sorts out the signals and edits them.  The thalamus can direct the feeling to different areas of the brain.  Some of those areas are connected with emotion, attention, and memory.   Most of us don’t draw our arms back from the needle because we remember that having our blood drawn is really no big deal.  We sit through the pain.  But for those of us that have a fear of needles…well…emotion takes over.  The thalamus, for whatever reason, directs those pain signals to the emotional center of the brain.  This explains why emotions have such an impact on our perceptions of pain.  When we are in a bad mood or feeling down, our perceptions of pain are intensified.  The pinprick is still a pinprick in reality, but when emotions take hold…that’s when it turns into a knife.  This is the concept that ancient Chinese medicine practitioners understood thousands of years ago - well before modern science made the connection.  Remember, in Traditional Chinese Medicine, there is no difference between emotional pain and physical pain.

As I said earlier, we all have the ability to “work through the pain”, and we all have the ability to increase our tolerance to pain.  Now the brain has its own pain-suppressing analgesic system where natural opioids such as endorphins play a key role.  Depending on the situation, you may not sense pain because the pain signals are suppressed.  Prescription pain killers work along these lines.  They mimic the natural opioids in the brain.  That’s one way to increase pain tolerance, but it certainly isn’t the best way and comes with serious risks.  In my opinion, that’s not really a good option for most people.  So let’s look at some other options.  Over time, the brain can rewire those pathways to become less responsive to certain kinds of pain.  Studies have shown that a positive attitude can overcome pain by releasing serotonin.  Breathing exercises have also been shown to reduce discomfort.  Professional athletes are known to become more accustomed to pain through repetitive physical training.  You can also look to the wisdom of Traditional Chinese Medicine.  Several common herbal medicines used in TCM pain formulas can help to alter your perceptions of pain without the risk of dependency.

 Let’s pull all the information from these 4 blogs on pain together into some take-away points. 

·         Pain is a physical and emotional response

·         Not all types of pain are inflammatory in nature

·         An obstruction of blood flow can lead to poorly nourished tissues and organs, which then can lead to pain

·         Stress contributes to the intensity or onset of pain

·         Pain is always subjective; the perception of which is influenced by emotion

·         Managing pain is a multi-pronged approach and should include support for both the body and mind

Some of the concepts presented in these pain blogs may be new to you, but keep in mind that they are not “new” in the general sense.  Many of these concepts have existed and have been applied for thousands of years as core tenets of Traditional Chinese Medicine, a system that is still in practice today.  Modern theories on pain are still developing and evolving and many of those theories are validations of these ancient concepts.  A holistic approach to pain is one that includes the theories of modern breakthroughs and the wisdom of historical philosophies; one that recognizes and appreciates the mind’s ability to influence the physical body and the potential to use that fact to our advantage.