The mysterious science of pain – Joshua W. Pate



In 1995, the British Medical Journal published an astonishing report
about a 29-year-old builder. He accidentally jumped
onto a 15-centimeter nail, which pierced straight through
his steel-toed boot. He was in such agonizing pain that even
the smallest movement was unbearable. But when the doctors took off his boot,
they faced a surprising sight: the nail had never touched
his foot at all. For hundreds of years, scientists thought that pain was
a direct response to damage. By that logic, the more severe an injury
is, the more pain it should cause. But as we’ve learned more about
the science of pain, we’ve discovered that pain and tissue
damage don’t always go hand in hand, even when the body’s threat signaling
mechanisms are fully functioning. We’re capable of experiencing severe pain
out of proportion to an actual injury, and even pain without any injury, like the builder, or the well-documented
cases of male partners of pregnant women experiencing pain
during the pregnancy or labor. What’s going on here? There are actually two phenomena at play: the experience of pain, and a biological
process called nociception. Nociception is part of the nervous
system’s protective response to harmful or potentially harmful stimuli. Sensors in specialized nerve endings detect mechanical, thermal,
and chemical threats. If enough sensors are activated, electrical signals shoot up the nerve
to the spine and on to the brain. The brain weighs the importance
of these signals and produces pain if it decides
the body needs protection. Typically, pain helps the body
avoid further injury or damage. But there are a whole set of factors
besides nociception that can influence the experience of pain—
and make pain less useful. First, there are biological factors that
amplify nociceptive signals to the brain. If nerve fibers are activated repeatedly, the brain may decide they need
to be more sensitive to adequately protect the body
from threats. More stress sensors can be
added to nerve fibers until they become so sensitive that
even light touches to the skin spark intense electrical signals. In other cases, nerves adapt to send signals more
efficiently, amplifying the message. These forms of amplification are most common in people experiencing
chronic pain, which is defined as pain lasting
more than 3 months. When the nervous system is nudged
into an ongoing state of high alert, pain can outlast physical injury. This creates a vicious cycle in which
the longer pain persists, the more difficult it becomes to reverse. Psychological factors clearly
play a role in pain too, potentially by influencing nociception and
by influencing the brain directly. A person’s emotional state, memories, beliefs about pain and expectations
about treatment can all influence how much
pain they experience. In one study, children who reported believing they
had no control over pain actually experienced more intense pain than those who believed they
had some control. Features of the environment matter too: In one experiment, volunteers with a cold rod placed on
the back of their hand reported feeling more pain when they were
shown a red light than a blue one, even though the rod was the same
temperature each time. Finally, social factors like the
availability of family support can affect perception of pain. All of this means that a multi-pronged
approach to pain treatment that includes pain specialists, physical
therapists, clinical psychologists, nurses and other healthcare professionals
is often most effective. We’re only beginning to uncover the
mechanisms behind the experience of pain, but there are some promising
areas of research. Until recently, we thought the glial cells surrounding
neurons were just support structures, but now we know they have a huge role
in influencing nociception. Studies have shown that disabling certain
brain circuits in the amygdala can eliminate pain in rats. And genetic testing in people with
rare disorders that prevent them from feeling pain have pinpointed several other
possible targets for drugs and perhaps eventually gene therapy.

34 comments

  1. this actually makes so much sense. i had a major hip surgery about 2 months ago and all my doctors and nurses and physical therapists keep telling me how well i’m doing and how positive i’m being when it honestly wasn’t hurting too bad. i obviously felt pain and some moments were almost unbearable, but for the most part i felt somewhat fine. i guess i didn’t really think oh this hurts i was just thinking oh this is very uncomfortable and i guess it changed the focus in my brain from pain to just uncomfortable. now i just feel muscle soreness in my hip and occasional intense pain but i’m still recovering and i feel i’ve done so much better than i thought i would

  2. TED Ed you had me until 4:00. Agree with everything in this video up until you advised a “multi-prong” approach including physical therapists and newfangled drugs that affect glial cells. I suffered from Chronic pain for about three years until it finally crippled me out of work and nearly out of my marriage. I was losing my wife, my kids, and probably at some point my life. It was a vicious cycle of pain that never ended. I lost nearly 70 pounds, did over a year of physical therapy and tried every drug imagineable. The only things left to me were steroid shots or surgery, neither of which I’m proud to say I ever did. Then one day I read the name Sarno. John E. Sarno. The man was a heaven-sent angel. I owe my life to him. For those of you that are curious, check out his book at your library or Amazon. He has the only true answer to solving the riddle of chronic pain. Earlier today I lifted my fifty pound daughter in one arm and my forty pound son in my other arm and had my thirty pound back-pack strapped to my back. Did I mention I have about six herniated discs in my spine?…Yeah, I didn’t feel a thing…except happy.

  3. This is how we experience "pain" in dreams, and is also the mechanism responsible for the electrifying feeling our bodies react with in response to jump scares. We should be more careful with how we define pain here though. The phrasing makes it sound as if you're implying the pain will be roughly if not on the same level to that of the anticipated affliction. When ultimately, the accuracy and similarity is completely up to the individuals insular cortex. Which even when functioning perfectly, seems to exhibit a sort of "padded" sensation that's much easier to cope with than if said pain were actually happening.

  4. YouTube is playing with me!!!!! received the notif just now. I determined I should be the first viewer and liker! 😭😭😭

  5. So now that everyone is talking about pain, lemme remind you that Tony Stark and Natasha Romanoff are dead :'(

  6. Aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa😂😂😂

  7. Why is it that when I sometimes hit my leg or any other body part, it wouldn't feel like anything, but then other times it would be so painful?

  8. I have Complex Regional Pain syndrome. This is a neurological chronic pain condition where my nerve misfire and cause severe pain where there is no injury. It's kind of like phantom limb syndrome where mirror therapy is very helpful along with all sorts of other therapies. CRPS has no cure yet, but I and the 200,000 Americans with CRPS are desperately waiting for something to put us out of our pain.

  9. Quite a few of you may have heard something like this or maybe even seen it. But the beggining of this reminded me of a story my dad told me. He said he was working in construction and a guy who worked with him had a pneumatic nail gun with no safety buffer so this thing shot nails like a projectile weapon. Somehow the guy shot himself in the side of his kneecap with the nail gun. My dad and another guy tried to pull the nail out with a pair of pliers, the guy screamed like crazy. So they put him in a car and drove him to the hospital. When they got there and got into a room 2 nurses came in followed by a doctor, the doctor says "what seems to be the problem here" and before the guy can say anything the nurses grab him and the doctor yanks the nail out with a pair of pliers. The guy said he didn't hardly feel it at all.

  10. Easy pain is two things

    Stepping on a lego and emotinal pain accidanly killing you're minecraft dog

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