How you feel pain
How you feel pain
Your experience of pain is part biology, but it's also influenced by psychological and cultural factors. Despite years of research, questions linger about exactly what happens between the moment you stub your toe and the moment you say "ouch."
How pain messages travel
Pain results from a series of exchanges among three major components of your nervous system:
How pain messages travel
Pain messages travel from the nerve fibers (nociceptors) on your peripheral nerves to your spinal cord to your thalamus — a message-routing station located deep inside your brain.
How you react to pain messages
Some of our current understanding of pain is based on the "gate-control theory," which grew out of observations of World War II veterans and their reactions to different types of injuries. The central concepts of gate-control theory are:
This last idea explains how your brain — and its psychological and emotional processes — can affect your experience of pain. In fact, how you interpret pain messages and tolerate pain can be affected by your:
For example, a minor sensation that would barely register as pain, such as a dentist's probe, can actually produce exaggerated pain for a child who's never been to the dentist and who's heard horror stories about what it's like. Fear and anxiety often increase the intensity of the pain experience.
But your emotional state can also work in your favor. Athletes can condition themselves to endure pain that would incapacitate others. And, if you were raised in a home or culture that taught you to "Grin and bear it" or to "Bite the bullet," you may experience less discomfort than do people who focus on their pain or who are more prone to complain.
The location of your pain can affect how you perceive it. Pain that you can escape by assuming a more comfortable position is easier to tolerate than a constant headache that interferes with work or concentration.
How you feel chronic pain
When pain persists longer than expected, it can become a chronic condition — in other words, an illness unto itself. Pain is generally described as chronic when it lasts six months or longer.
Chronic pain may remain constant, or it can come and go, like the pain of migraines. As with acute pain, chronic pain can feel:
Sometimes, chronic pain is due to a chronic condition, such as arthritis, which produces painful inflammation in your joints. Chronic pain may also stem from damage to a peripheral or spinal nerve. This type of nerve pain is called neuropathic (noor-o-PATH-ik) pain — meaning the damaged nerve, not the original injury, is causing the pain.
Nerve damage can result from:
Occasionally, the cause of chronic pain isn't well understood. There may be no evidence of disease or damage to tissues that doctors can directly link to pain. Or pain may remain after the original injury shows every indication of being healed.
If you have a mood disorder such as depression or anxiety, you're more likely to experience chronic pain — and to feel it more intensely — than do people without a mood disorder. Treating mental health conditions can improve or even eliminate chronic pain.
Sensitization turns up the pain volume
In the peripheral nervous system, sensitization can result from inflammation, which causes your nociceptors to fire with greater intensity, for a longer time and at a lower threshold than usual. In the spinal cord, sensitization is the result of chemical reactions that increase pain messages being sent to your brain. Sensitization may affect all the pain-processing regions of your nervous system, including the sensing, feeling and thinking centers of your brain. When this occurs, chronic pain may be associated with emotional and psychological suffering.
Pain researchers are focused on identifying the biology that underlies sensitization. They're also investigating other genetic and psychological factors behind how you feel pain, with the goal of developing new and better pain treatments.
Last Updated: 2009-02-13
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