A 1995 British medical journal describes the case of a 29-year-old builder who suffered excruciating pain after stepping on a 15-cm nail on a building site. The nail passed through his foot and protruded a few centimetres above it. He was taken to hospital and had to be anaesthetised because the pain was so intense. The medical staff were astonished when they removed the nail and found no trace of any injury – not even a scrape. The nail had passed between two toes! So why did he experience such severe pain that he required an anaesthetic?
In Explain Pain (2010), Dr David S. Butler and Prof G. Lorimer Moseley (pain specialists) provide an extremely detailed account of how the neurological process of pain operates. Until very recently it was believed that “pain sensors” in the skin and muscles cause us to feel pain from an injury such as a cut. Research has shown that this is not true. We have so-called “nociceptors”, a type of sensor that sends messages to the brain as soon as we suffer an injury. These are not sensors for pain, however, but for danger. When a nociceptor “believes” there is a risk of danger, it sends a signal to the brain and as soon as the brain “agrees” that there is danger, pain results. If not, there is no pain.
Researchers have found that the degree of pain we experience from an injury has very little to do with the actual extent of the damage. The intensity of the pain is directly related to the brain’s perception of danger. This makes sense, because the purpose of pain is to prevent further damage, and ultimately to ensure survival.
If one has a broken leg, the purpose of the pain is to prevent one from putting any weight on it; the pain ensures that one will not walk on the leg and make the injury worse. But in the midst of battle a soldier would be able to walk on a broken leg without great pain because the brain interprets the situation in a very clever manner: it would be more dangerous to be trapped by the enemy (who could kill one) than to walk on the broken leg and thereby reach safety. And naturally the leg will become painful as soon as the soldier reaches a safe place and his life is no longer in danger! Many people have experienced something of this sort; for example one might have a severe headache but it would vanish if one were to narrowly escape cutting off one’s finger with a sharp knife.
The interesting thing is that the brain performs its risk analysis in different ways: that is, on the basis of external circumstances (such as whether you are in a conflict situation or relaxing on a safe beach), or on the basis of what is happening inside your body (a fracture or a soft tissue tear or simply a bruise), and it also responds to thoughts. Butler and Moseley speak of a “thought virus” which could cause prolonged pain long after full physical recovery. In one experiment, for example, patients who had already recovered from an injury were simply asked to recall the incident that had caused the injury. This reactivated the area in the brain that assesses risk and the pain came back. The reaction was so powerful that the pain was even accompanied by swelling!
Do we have any control over pain? Many people have found that they are able to control pain. Consciously and unconsciously. People will say: “The more I think about it, the worse the pain gets.” Or, “If I watch TV for a short while, I feel better.” For example, if one becomes anxious about a tension headache, or annoyed about the waste of time, or if one begins to wonder if one is developing an illness, the pain may well become worse, because one’s brain senses danger.
The results of pain studies raise the question: How far can we trust the images of the so-called objective reality we receive from our brains every day? If the mere thought of an incident that resulted in an injury can cause pain and swelling … wow, our brains are certainly capable of deceiving us! Think of the phenomenon of optical illusions. How can we trust our own senses? Where does the line between reality and fiction lie? What can we rely on as “the objective reality”? In my opinion these studies provide further confirmation that what we experience depends on our personal reality.
Remember that the brain does not draw conclusions on the basis of objective, empirical reality. The brain guesses what the most probable answer would be. And at times the brain may be completely wrong. Then you and I have to make corrections, for instance by restricting “thought viruses” to the minimum.
It is liberating to gain insight into the way pain works. Suppose you wake up with a headache. Whereas normally you might immediately become stressed about the implications for your day (in other words a “thought virus”), you might decide instead to breathe deeply and relax, while telling yourself a few times: "I am safe, it’s only a headache. It could go away without medication if my brain understands that I am safe."
Insight into the way the brain interprets danger signals tells us that the way we care for patients in hospital is very important, especially after an operation. Patients who feel safe and are receiving good care experience far less pain.
If a child gets hurt it can be very valuable if the parent remains calm and conveys the message to the child (and therefore to his brain as well!) that everything is under control.
(Sources: Your Everyday Superpower by Janette Dalgliesh; Explain Pain by Butler and Moseley.)
In Explain Pain (2010), Dr David S. Butler and Prof G. Lorimer Moseley (pain specialists) provide an extremely detailed account of how the neurological process of pain operates. Until very recently it was believed that “pain sensors” in the skin and muscles cause us to feel pain from an injury such as a cut. Research has shown that this is not true. We have so-called “nociceptors”, a type of sensor that sends messages to the brain as soon as we suffer an injury. These are not sensors for pain, however, but for danger. When a nociceptor “believes” there is a risk of danger, it sends a signal to the brain and as soon as the brain “agrees” that there is danger, pain results. If not, there is no pain.
Researchers have found that the degree of pain we experience from an injury has very little to do with the actual extent of the damage. The intensity of the pain is directly related to the brain’s perception of danger. This makes sense, because the purpose of pain is to prevent further damage, and ultimately to ensure survival.
If one has a broken leg, the purpose of the pain is to prevent one from putting any weight on it; the pain ensures that one will not walk on the leg and make the injury worse. But in the midst of battle a soldier would be able to walk on a broken leg without great pain because the brain interprets the situation in a very clever manner: it would be more dangerous to be trapped by the enemy (who could kill one) than to walk on the broken leg and thereby reach safety. And naturally the leg will become painful as soon as the soldier reaches a safe place and his life is no longer in danger! Many people have experienced something of this sort; for example one might have a severe headache but it would vanish if one were to narrowly escape cutting off one’s finger with a sharp knife.
The interesting thing is that the brain performs its risk analysis in different ways: that is, on the basis of external circumstances (such as whether you are in a conflict situation or relaxing on a safe beach), or on the basis of what is happening inside your body (a fracture or a soft tissue tear or simply a bruise), and it also responds to thoughts. Butler and Moseley speak of a “thought virus” which could cause prolonged pain long after full physical recovery. In one experiment, for example, patients who had already recovered from an injury were simply asked to recall the incident that had caused the injury. This reactivated the area in the brain that assesses risk and the pain came back. The reaction was so powerful that the pain was even accompanied by swelling!
Do we have any control over pain? Many people have found that they are able to control pain. Consciously and unconsciously. People will say: “The more I think about it, the worse the pain gets.” Or, “If I watch TV for a short while, I feel better.” For example, if one becomes anxious about a tension headache, or annoyed about the waste of time, or if one begins to wonder if one is developing an illness, the pain may well become worse, because one’s brain senses danger.
The results of pain studies raise the question: How far can we trust the images of the so-called objective reality we receive from our brains every day? If the mere thought of an incident that resulted in an injury can cause pain and swelling … wow, our brains are certainly capable of deceiving us! Think of the phenomenon of optical illusions. How can we trust our own senses? Where does the line between reality and fiction lie? What can we rely on as “the objective reality”? In my opinion these studies provide further confirmation that what we experience depends on our personal reality.
Remember that the brain does not draw conclusions on the basis of objective, empirical reality. The brain guesses what the most probable answer would be. And at times the brain may be completely wrong. Then you and I have to make corrections, for instance by restricting “thought viruses” to the minimum.
It is liberating to gain insight into the way pain works. Suppose you wake up with a headache. Whereas normally you might immediately become stressed about the implications for your day (in other words a “thought virus”), you might decide instead to breathe deeply and relax, while telling yourself a few times: "I am safe, it’s only a headache. It could go away without medication if my brain understands that I am safe."
Insight into the way the brain interprets danger signals tells us that the way we care for patients in hospital is very important, especially after an operation. Patients who feel safe and are receiving good care experience far less pain.
If a child gets hurt it can be very valuable if the parent remains calm and conveys the message to the child (and therefore to his brain as well!) that everything is under control.
(Sources: Your Everyday Superpower by Janette Dalgliesh; Explain Pain by Butler and Moseley.)
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