How Pain Works to Protect Us, and Why it Becomes Chronic

When people have pain or think of uncomfortable feelings in their body, they often want to get rid of them as quickly as possible. Especially in chronic cases where pain can last for months, years, or decades, it may seem like the pain is impossible to escape. But there is a lot of new research coming out of clinics in various parts of the world looking at pain and how it might actually help the body survive and adapt to certain situations.

The first thing to remember is that pain is the body's natural response under various conditions. When the brain believes it has encountered a threat to the tissues, it creates a feeling of pain in order to get the person to stop that activity. For instance, if there was no pain when touching a fire or hot surface, this would not mean that the tissues are not being damaged. In fact, the damage would continue, but without pain, the person may just allow the damage to completely destroy the skin and other tissues. Pain gets us moving away from what the brain perceives as dangers to our health and well-being.

But pain is also funny in that the amount of pain a person experiences does not indicate the amount of tissue damage they have suffered. Almost all of us have had an experience where we suffered an injury while playing a sport or working with construction equipment but have not even noticed it until there was blood all over the place. The tissues suffered significant damage, but the brain did not start ringing the pain alarm until there was more input from the sight of the blood. On the other hand, we have all also had the experience of a small paper cut causing a lot of pain and discomfort. So a pain message may not indicate the true level of tissue damage.

The example above of the injury that does not hurt until the person sees that they are bleeding profusely serves as an illustration of the next principle of pain. The brain, when determining whether or not to send a pain message to indicate danger, uses a variety of sensory inputs to construct its message. There are a lot of different sensors in the body to detect tissue damage, but it is the brain that puts together all of the cues from the nerves in order to construct the feeling of pain. If the cues are not judged to be sufficient enough, the brain can ignore them and not cause the painful feelings.

Finally, people with chronic pain should keep in mind that the brain has two bodies that it monitors for pain: the actual body and a virtual body that exists only in the brain. This is why people who have missing legs and arms can "feel" their missing body parts -- the brain is accessing them through its virtual body. So long after actual tissue damage has been repaired, the brain may still be constructing pain messages based on its virtual representation of that part of the body, which may not reflect what is actually happening in the tissues.

All of these new discoveries and paradigms for looking at the phenomenon of pain can help people suffering from chronic diseases and syndromes. Since we know that pain is caused by a myriad of sensory inputs, and that the actual condition of the tissues may have healed years ago while the pain still persists, it may be a problem mainly in the nervous system. Or maybe the nerves have become overly sensitized to painful feelings and are using any sensory inputs to cue an overly sensitized brain to keep hitting the pain alarm. But this still may have little to no relation to what is actually going on in the body's tissues themselves.