Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

About PAIN

Posted by Sharon W on 6/13/03 at 16:37 (121784)

I found an article about pain by Carl Y. Saab. of Yale, courtesy of of a post on 'braintalk.org,' and I thought the guy's theory was quite interesting. I wanted to share it with you (exerpts follow):

http://www.painonline.org/LittleBrain.htm

By Carl Y. Saab, Ph.D. Yale/VA

'HOW PAINFUL IS YOUR PAIN?'

'When I volunteered for a pain study, an increasing pressure was applied on my finger by a simple weight-drop machine while researchers where acquiring fMRI scans of my brain ‘in action' (or rather ‘in reaction' to the painful stimulus). When the increasing pressure reached my pain threshold, I was asked to rate my pain on a scale of 1 to 10, with 10 being the most imaginable pain. I rated my pain back then as 7. A few weeks later I read the following in Discipline and Punish by M. Foucault (1995):'

'On 2nd of March 1757, Damiens the regicide was condemned […] to be taken and conveyed in a cart, wearing nothing but a shirt, holding a torch of burning wax weighing two pounds, then, in the said cart, […] the flesh will be torn from his breasts, arms, thighs and calves with red-hot pincers, his right hand, holding the knife with which he committed the said parricide, burnt with sulphur, and, on those places where the flesh will be torn away, poured molten lead, boiling oil, burning resin, wax and sulphur melted together and then […] his limbs and body drawn and quartered by four horses and […] consumed by fire, reduced to ashes and his ashes thrown to the winds'.

'Was Damiens' pain the most imaginable? How could I have rated my pain as 7 compared to the suffering of Damiens, which is indeed almost unthinkable? How valid was the pain rating in that study after all? How do clinicians and pain patients get along on this level? These were the questions I brought with me to the laboratory as a pain researcher, and these were my concerns with the ‘pain' terminology over which patients, clinicians and basic scientists often clash.'

...

'A hypothetical model for the little brain and pain'

'Assuming the cerebellum is indispensable for the establishment and regulation of automated motor behavior, why would the cerebellum not also be involved in the regulation of a sensory behavior? Or rather, based on the above information, ‘how' would the cerebellum conceivably affect our sensation?'

'In a situation where Jack twists his ankle, he initially feels pain aggravated by any attempt to move it around. As Jack goes about his daily routine, he is forced to concentrate on his gait while limping to minimize further damage and allow rapid healing. By concentrating, he is allegedly engaging his frontal lobe more than usual, whereas before his accident when his walk was almost automated, he probably used to depend less on his frontal lobe and more on his cerebellum. After using crutches a few days, Jack will walk faster and with more confidence; he probably had enough time to train his cerebellum to take over again and to learn how to walk differently, as he once learned how to ski or ride a bike. When Jack lets go of his crutches next month, thanks to physiotherapy, he will be treading along ‘unconscious' of the workings of his cerebellum that marvelously corrected those error signals generated by the pain in his ankle. In addition to optimizing his use of the injured limb, the cerebellum might have regulated his brain stem analgesic centers (to which it is extensively connected) to lessen the pain by releasing endogenous opioids'.

----------------------------------------------------------------------

An interesting theory, I thought...

Sharon
.

Re: About PAIN

wendyn on 6/13/03 at 19:39 (121801)

Very interesting article Sharon...I wonder if this is why, when I used to keep a 'pain journal' I think I actually felt more pain. I was too focused on what was happening in my body.

Re: About PAIN

Sharon W on 6/13/03 at 23:46 (121831)

Wendy,

I am quite certain that focusing in on your pain can make you feel it more intensely. I'm sure you already know this -- but many people do not realize that pain is actually 'felt' by their BRAINS, not by whatever part of the body is perceived to be causing it. That's why 'distraction techniques' like the TENS machine are successful for many people in treating pain. If you can keep your brain from paying attention to the pain, you won't feel it. Hypnoanesthesia (hypnosis used for anesthesia) works on the same principle -- and highly susceptible people are sometimes able to use hypnosis instead of an epidural (or whatever) for childbirth. There have even been situations where specialists trained in hypnosis techniques have used it for SURGERY (usually in cases where the patient was highly allergic and couldn't tolerate any of the usual anesthetics used for surgical procedures).

ON the other hand, I do believe that keeping a pain journal, for a SHORT period of time, can help a person to come to terms with what is happening in their body. It is especially useful if there is some sort of a denial problem going on... I know that keeping a journal for a couple of months helped ME to sort things out.

Sharon
.

Re: About PAIN

wendyn on 6/13/03 at 23:55 (121833)

You're absolutely right Sharon. I did find a pain journal helpful (for a period of time). It helped me realize that not ALL of my days were that bad. But I did come to a point where I had to let it go.

Pain itself is strangely fascinating - especially when it comes to something like RSD where the body is essentially self-generating pain for no good reason.

I can't remember - were you ever diagnosed with RSD?

The absolutely weirdest thing about RSD is that when I'm startled (i.e. a dog runs out in front of my car) - I actually FEEL the pain of the my nervous system firing. It lasts a split second but it feels awful. I guess it's due to the miswiring of my nerves. I don't think I've ever read about it anywhere - but I think there was someone else here who had noticed it.

Re: About PAIN

john h on 6/14/03 at 14:25 (121868)

For a few years I kept track of my pain level each day with the calendar on my computer. I also might make a note of my activity level, weather,etc to see if I could find some correlation. Never could tie pain level to anything in particualr unless I really did something big like walk 4 miles.

Re: About PAIN

BevN. on 6/14/03 at 16:59 (121875)

Wendyn,

Do you have RSD? If so may I e-mail you with questions on it? Thanks. Bev

Re: About PAIN

wendyn on 6/14/03 at 18:17 (121878)

Yes - and Yes

my email is mailwendy1 @ shaw.ca (remove all the spaces)

I am notorious for not returning emails in a timely manner (still working on it Rick) but I will do my best!! (There are times when I am only on the email/internet for a few minutes a day...but then there are times like now when I'm avoiding homework...which means I spend more time on the net!!!

Re: About PAIN

Sharon W on 6/14/03 at 20:40 (121886)

Wendy,

Nope, I've never been diagnosed with RSD and while I probably do have SOME kind of chronic pain syndrome by now, I don't think that's what it is. I do have color changes in my feet and hands sometimes, and sometimes in the past (before my TTS surgery) I used to have 'cycles' of shooting nerve pains where it seemed like one nerve excitation didn't have time to finish before another one started... (that really isn't a very good description, but I can't think of a better one!) Anyway, the cycles of shooting pains are a thing of the past, and Neurontin usually controls most of the constant tingling and frequent burning. So I'm in pretty good shape now, and glad for it!

My current quest is not for pain reduction, it's to find out the cause of my peripheral neuropathy and get treatment for it before it gets worse.

Sharon
:)