You know that feeling when you stub your toe on a chair leg? Or the soreness of an itchy
sunburn a couple days after the exposure? What about the intense unpleasant sensation of passing a kidney stone? Ouch. That’s painful. There are pains that we can feel in localized areas, which we call physical pains. We all know what that feels like! But then there are other pains: the anguish of losing a child to cancer, the heartbreak that accompanies the end of a close friendship or serious relationship, the types of pain that seem to continue long past the initial event. Are these feelings considered “pain” as well?
The science community emphatically says NO. Pain, as defined by the International Association of the Study of Pain says that pain is “An unpleasant sensory and emotional experience associated with actual or potential tissue damage.” This means that pain has to be sensed by your body and interpreted in your brain in order to be pain.
How does pain work? When something happens to you, such as stubbing your toe, little receptors in your nerves, called nociceptors, send signals to the brain that say “hey! That doesn’t feel good! Change it!” This signal is what makes you shy away from whatever injured you. Example: If you touch hot metal, you move your hand away as quickly as possible. This is a way for your body to protect your skin from further injury. This is what science calls “pain.” It is a complex process of signals to and from the “pain centers” in your brain.
Seems pretty cut and dry, right? Well, here is where the scientific explanation runs into problems. When you experience a traumatic event like mentioned in the beginning of this article, the same “pain centers” of the brain light up. Essentially, feelings of depression, grief, and anguish trigger the same biological response as passing a kidney stone; very different experiences that result in the same brain signals. There is a slight difference though- psychological pain doesn’t involve nociceptors. Without the communication with the nociceptors, these experiences aren’t classified as pain.
If this is really what happens when we feel “pain,” then why do we often describe psychological stress as painful? Pain is an abstract idea. We can’t touch it, smell it, hear it, see it, or taste it, so it’s hard to describe to other people. The best way that we can express the feeling of pain then is through metaphors. The most common metaphor for pain is weapons. We think of pain as piercing, drilling, burning, grinding, throbbing, stinging, squeezing, and so on. Each of the descriptors implies the presence of a weapon: the drill that drills or the fire that burns. It’s a way for us to objectify pain so that we can make connections. Psychological stress is also an abstract idea. Often we use the same metaphors to describe our mental stress as we do our physical stress, which blurs the lines between physical pain and psychological stress. They are similar sensations in the brain, so we describe them in a similar way. Because medical science doesn’t recognize psychological pain, people suffering from depression and other stressors often turn to the “softer” sciences, such as psychology, to get their needs met. Unfortunately, this often results in them being treated as “second class” patients.
Even with the separation of psychological and physical pain, there are a few cases that cannot be explained. Patients that suffer from chronic pain or fibromyalgia are exceptions to the rule. Suffering from pain that doesn’t have a visible cause can be frustrating. We put these people in a limbo state: on one hand they are experiencing physical pain because it is in a localized area, but on the other hand there is no detectable injury so it seems to fit in the psychological category. For a long time, these patients were handed back and forth between psychologists and physicians. With current pain clinics and chronic pain management seminars, the lives of these individuals have improved and this doesn’t happen as often; but they still get stuck in limbo every once in a while. How can we change this? Maybe we need to take a democratic approach and say that “all pain is created equal.” If we could put both physical pain and psychological pain on a continuum, then we might be able to cater to all the needs of patients in pain.
So, is pain purely physical? Science would say yes, but I would disagree. Pain is subjective: everyone feels it differently because they have had different life experiences and circumstances than the person next to them. There are different classifications of pain, both psychological and physical, and I believe that they all hold weight in the medical world. The mysteries of the human body will never cease to be unraveled. With further research, we might be able to answer this question more fully. Until then: What do you think?
Penelope is a regular contributor to firstmedicalproducts.com a retailer of TENS units and ultrasound therapy machines used to treat back pain and other muscle pain resulting from athletic injuries.