Can I bet everyone is aware of pain?

Part 1: Introduction

Pain perception

Nobody honestly likes pain. Perception of pain is so vast that it can spread from a simple cut in daily chores to terminal cancer pain. While pain is certainly uncomfortable, it serves an essential purpose as a signal from our bodies that something is wrong. We can consider it a warning sign or information on which we must act immediately. Sometimes, defining the simplest things to include its holistic character is the most difficult.
Pain is defined as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” by IASP (International Association for the Study of Pain). IASP is the supreme authority over pain study, research, and intervention. Notice carefully, even if they put the unpleasant word first to identify it. Doctors usually divide pain into two categories based on the chronicity of pain duration. First is acute pain, which occurs suddenly, is connected to an injury or illness, and fades away with healing/time. Another type is chronic pain, lasting longer, often for months or even years. Apparently, this type does not help us by giving information about some problems and mostly acts as a problem.
We all are aware of arthritis or migraines, but there are other syndromes, such as fibromyalgia and chronic regional pain syndrome. These are typical chronic pain illnesses, and they can be severely debilitating and cause significant loss of quality of life.

In this series, we will be talking about our recent article on Pain published in Science Reporter (niscpr.res.in) in April 2024

Pain control

This is most useful for situations where the pain is a problem and causes morbidity and is not merely a signal for an existing or ongoing injury in the body. Let’s begin with tried-and-true solutions such as rest, heat and cold therapy, painkillers, distraction, and emotional support. Usually, these options work, and patients get relief. Chronic pain is notoriously relapsed soon after cessation of drugs, and the side effect of drugs is also a concern. Many situations need proper medical attention from a specialist.

Pain Receptors

Now, let’s understand how pains reach our brains. Consider reading a magazine page like this one. We register information from the eyes, and then the brain decrypts the characters’ meanings and develops insight. And, later, kept reading or turning the page to the next. Just replace the eyes with nociceptors; as the name says, tiny receptors exist for pain perception. They are spread all over the body. There are significant details of subtypes and their functioning. But discussing that is beyond the scope of the article now. They are so special and important that David Julius and Ardem Patapoutian were awarded the 2021-year Nobel Prize for their work.

So, without digressing much, let’s focus there again. Nociceptor sends information to the brain via a highway known as the spinal cord. Please note carefully that as many cars are going on the highway, other nerve fibres carry non- painful signals, such as touch, temperature, or vibration, which are also there in the spinal cord. These non-pain signals are thicker, resulting faster than those carrying pain. So, not all signals of pain make it to your brain.

Interestingly, they can also influence how much pain we feel by opening or closing a “gate” in our spinal cord. And this is the gate control mechanism of pain from the mid-sixties. Indeed, there are many new insights in neuroscience.

If the brain receives the signals in all conditions, we feel pain. Somehow, all these gates are shattered, and other backups are triggered, causing even more pain.

So! why not let’s talk to the brain and change it so we can treat this huge misery of patients?

-Vikku (original author)