The Science of Pain: Understanding Our Body's Alarm System

in StemSocial3 months ago

When fighting in a boxing ring and a punch is launched at your face, you will feel an unpleasant sensory and emotional experience associated with the damage to the tissue of that area. That feeling is what is regarded as pain. According to the International Association for the Study of Pain (IASP), "pain is an unpleasant sensory and emotional experience that is associated with, or would resemble that associated with, actual or potential tissue damage." Pain can be acute or chronic. Acute is pain that has just begun, and chronic pain is pain that has been existing for three months or more.

Pains can be experienced in two aspects, the sensory experience, and the affecting experience. The sensory signal is translated from the pain receptor where the pain is felt, helps to identify the type of pain, and is known as the sensory experience, while the emotional reaction to such pain is referred to as the affecting experience. Pain serves as an indicator of underlying damage to tissue, and can also occur when there is no damage to tissues. Pain is usually subjective, as you cannot feel it for the person feeling the pain, and when the sensory input is regarded as painful, then the pain threshold has been reached and when a person is feeling pain with sensory inputs that would normally not cause pain, it is regarded as Allodynia. Individual pain tolerance differs from one another as one person might experience pain and not worry about it while another person might experience the same pain and it triggers the emotional experience. This is influenced by some factors which can be biological, psychological, and social. Nociceptors, basically the primary afferent nociceptors are pain receptors that detect pain at the end of the tissues and send them through the afferent sensory nerves which are part of our peripheral nervous system. There are two types of fibers that would transmit pain, and they are the C-fibers (which have a small diameter, are unmyelinated, and transmit pain in a slow and dull manner), and the A-Delta fiber is the second type of fibers. They are large in diameter, are myelinated, and transmit sharp and localized pain sensations very fast. The pain sensation goes to the spinal cord from the fibers through the spinothalamic tract and the spinoreticular tract and then goes to the cortex and the thalamus of the brain for interpretation.

Pain sensory input can be mechanical such as pressure, chemicals such as acid burns, and prostaglandins and heat. Referred pain is pain experienced away from the site of the tissue damage. This is common with patients with a heart attack feeling pain in the arm, and patients with appendicitis feeling pain on the other side of the stomach. This can happen when the areas where the damage occurs share nerve innervation with the region where the pain is being referred. Another type of pain is neuropathic pain which is the pain that occurs as a result of damage to the sensory nerves, which will result in signals being sent to the nervous system sporadically. People with neuropathic pain are sensitive to touch or cold or other stimuli that will normally not cause pain in ordinary people.

Since pain is subjective, its measurement can only be done using Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS). The visual analog scale has in its left no pain and in its right extreme/ worst pain imaginable. The patient will tell the level at which they feel the pain since it is subjective to them. While with a numerical rating scale as the name implies, patients rate their pain on a numerical scale. For cancer-related pain, the analgesic ladder is used. These pains are acute and chronic and patients with mild pain will indicate at the lower part of the ladder and the more severe the pain, the higher the ladder can be used to illustrate the pain. When using analgesics the first ladder will be treating the patient with non-opioid medications such as NSAID and paracetamol, the second ladder will be treated with weak opioids like Codeine and tramadol, and the highest step will involve treating with strong Opioids such as Oxycodone, morphine, and fentanyl.

While treating with analgesia, there can be side effects and one of them is medication overused headache which is a side effect of long-term use of analgesia. When using NSAIDs excessively it can lead to side effects like Gastritis, Indigestion, Stomach Ulcers, Asthmahigh blood pressure, Hypertension, and Renal impairment. Opioids can lead to side effects like Constipation, Pruritis, Nausea, respiratory depression, Sedation Cognitive impairment, and other altered mental states.

Chronic pain can be confirmed when a person has had continuous pain in one region for more than 3 months. Chronic pain can include headache, lower backpain, joint pain, and neck pain. Chronic pain can be chronic primary pain and chronic secondary pain. In chronic primary pain, there is no evidence of an underlying issue causing the pain, and as expected with chronic secondary pain, there is an underlying condition causing the pain. Chronic secondary pain can be caused by osteoarthritis, Traumatic injury, irritable bowel syndrome, migrane, cancer, neuropatic pain and so on. This pain can remain consistent as a result of biological, socail, and psychological factors. This type of pain can be increased through physical processes such as sympathetic nervous system increased activities and increase muscle contraction in respect to the pain.

Rounding Up

Understanding to what extent a person feels pain is still an unaddressed issues, pain is morally imperative.While pain is regarded as unpleasant, it serves as a warning signal that our tissues are about to be damaged, or are damaged already. Understanding the underlying cause of any pain will be able to assist physicians with the effective strategies to management and help relief the pain.



There are certain levels of pain that humans can control, but when it becomes chronic, is when we like to find our way to the hospital. I truly feel going to the hospital under a simple feeling of pain will aid in faster treatment.

Yay! 🤗
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