Pain is just another emotion

What is pain

The International Association for the Study of Pain in 1994 defined pain as “an unpleasant sensory emotional experience” associated with actual or potential tissue damage, or described in terms of such damage

This definition of pain emphasizes that pain is an “experience.” It emphasizes the brain’s central role in the body perception, creation, and maintenance of the pain experience.   Pain is now recognized to be a multidimensional phenomenon combining several components: [a] sensory-physical; [b] emotional; [c] cognitive; and [d] descriptive.  

The Neuroanatomy of the Pain Pathways. The neuroanatomy of pain-related sensory processing has become increasingly complex. Decades ago the emphasis of medical teaching was on the incoming [ascending] nerves and pathways that carried “painful” sensations from the tissues to the brain. With advances, it is now known that the multiple brain regions send outgoing [descending] signals that can increase or decrease the intensity of the incoming signals.

 The important principle is that pain is not just passively received by the brain. The brain has multiple active methods to actually increase or decrease the intensity of incoming pain signals. This is actually well-established in clinical medicine and is embodied in such notions as the placebo response, natural endorphins, and personalised “pain thresholds.”

 The second concept that has emerged is that the pain experience involves signal processing by multiple brain regions that seamlessly interact to create what the patient experiences and describe as “pain.” Many of these brain regions are also now known. Advanced scientific imaging techniques [such as functional MRI and volumetric CT scan] demonstrate metabolic and anatomic changes affecting these brain regions in chronic pain syndromes.

The important aspects of pain for an expert is to recognise that pain is a multifaceted emotion and it is not always explained by findings on an x ray or an MRI scan