Oh, The Pain…

Oh, The Pain… - I READ that Lady Gaga suffers from a condition called fibromyalgia, which causes her to suffer pain all over her body. But why do some people feel more pain than others?

Let us understand what pain is in the first place.

Pain is an interaction between specialised pain nerve fibres that exist on your skin and the surfaces of some of your other body organs.

That sounds complicated. What do these nerve fibres do?

Let’s illustrate an example. You prick your finger on a needle and you feel the pain. You say, ‘Ow!”

Between the time you pricked your finger and felt the pain, and far before saying “Ow!”, there are many interactions happening.

1. The needle immediately causes skin and tissue damage on your finger.

2. This is registered by very tiny pain receptors (nocireceptors) in your skin.

3. Each pain receptor is actually the end of a nerve cell, or neuron.

4. The neuron is connected to your spinal cord through a long nerve fibre called an axon. Many axons are bundled up together to form a larger peripheral nerve.

5. Electrical signals travel up this axon into the peripheral nerve, and into an area in your spinal cord called the dorsal horn.

This dorsal horn is located nearer to the skin of your back.

6. Nerves are connected to each other via synapses. There is a gap between these synapses. Electrical signals have to be converted to chemical signals that are transmitted through specialised chemical neurotransmitters.

7. Chemical signals are converted to electrical signals again, which pass up the spinal cord.

8. The spinal cord relays the signals to the thalamus, a part of your brain. This is a sort of relay and sorting station where the signals are then relayed to other different parts of your brain.

9. In the case of pain, the signals are sent to the sensory cortex of your brain, which is in charge of feeling physical sensation.

10. But this pain signal is also sent to the frontal cortex of your brain, which is in charge of thinking, and also, your brain’s limbic system – in charge of emotions.

So if the pain signal goes to so many parts of my brain, what does it mean for me exactly?

Not only do you feel the physical sensation of pain, you know exactly where it is located (your finger).

You think the feeling is very unpleasant (emotion), and you immediately withdraw your finger (thinking). You may also feel irritated, anxious, miserable or panicky (all emotions).

What you feel and how you perceive this pain, and also, how you react to it, varies from one person to the next.

If you are Sleeping Beauty, for example, you’d be very wary of sharp needles on spindles next time!

If you are a person used to acupuncture, you may have conditioned yourself to be okay with the sensation of needles entering your skin.

Are there many types of pain?

Yes, definitely. There are:

Nociceptive pain – These include cuts; damage to your tissue, burns or broken bones; and even post-surgery pain and cancer pain.

This is usually caused by injury to your body.

Nociceptive pain can be described as sharp, throbbing or aching, depending on where it is located or the cause.

Neuropathic pain – This is caused by issues in the nervous system that carries and interprets the pain. The issue may be in your nerves, spinal cord or brain, and may be caused by many things, including damage to the nerves or spinal cord, or an overactive nerve signalling system.

Lady Gaga’s fibromyalgia is often seen as a neuropathic pain.

This type of pain may be described as burning, tingling, shooting, or an electrical-shock type of sensation. People who feel this may be more sensitive than normal to light touch.

Psychogenic pain – This pain often has a physical cause. But the degree and problems it causes the person is out of proportion to what other people would experience.

This type of pain may also be due to learned and psychological factors.

Example: A woman who has been badly burned in a house fire, but survived, may come to regard any type of burn from now on as extremely painful.

Why do some types of pain abate quickly but others persist for a long time?

There is acute pain, which is short-lived.

Its purpose is to warn your body that damage is occurring and for you to get out of harm’s way.

It will resolve when the damage has been repaired or when that part of your body heals.

The other type is chronic pain, which can be caused by ongoing damage for a long time, for example, rheumatoid arthritis.

Sometimes, it goes on long after the damage has been repaired because of neuropathic and psychological factors.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.