Pain – why do we feel it so differently?

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Pain, it can last seconds or a lifetime. It is essential for our survival and protects and alerts us to danger. Why do we feel it so differently? Do the differences lie in our DNA or in our brain?

Pain and Genetics

There are hundreds of genes involved in our pain mechanisms. Cambridge University have studied the DNA of the few people in the world who feel no pain. They discovered these people all had a mutation in one gene, SCN9A. This gene regulates the electrical signals which transmit pain messages to the brain, but is not critically involved in other systems with in the body. This is a pharmaceutical dream. I am sure the drug companies are racing to be the first to discover and patent a block to this gene which can be used as a pain relief in normal people. Key life experiences are proving to be just as important as genes, with events in early life affecting our perception of pain. As we grow our senses, including pain, develop according to the experiences we are exposed to. Early life experiences may strengthen or weaken our pain pathways and our in turn affect how our pain system is wired up and how we experience pain.

Scientists believe the answer lies deep within our mind. There can be a mismatch between the pain we feel and extent of our injury. Our experience of pain can be changed by our moods and the context we are in. Anxiety can increase our perception of pain and situations of extreme survival can turn pain down by blocking pain signals entering the brain and flooding the body with natural painkillers. So at last the proof we are looking for. You know we do it and you often tease us about it. Why, when we are asking you to do something uncomfortable, do we then enquire about your weekend or your pet? We both know it allows us to push you further!!

A unit in Seattle for burns victims has put together the research on pain sciences to improve treatment for their patients. Armed with the knowledge that pain is generated in the brain and has a strong psychological component they have focused on reducing pain by altering where attention is directed. For burn victims the healing process can be as painful as the injury itself and Physiotherapy sessions aimed at restoring movement are especially gruelling. In Seattle, burn victims undergoing Physio enter ‘Snow World’, a computer-generated virtual reality, and become so distracted they are oblivious to treatment. The brain can only process so much information at one time, and with much attention allocated to virtual reality, the perceived pain is less.

While we think about installing an Xbox in our treatment room you might like to watch this TED talk by fellow Physio Lorimer Moseley explaining why things hurt!



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