The treatment of pain is a tricky business

By Ben Chatterton

All of us have experienced pain at one point or another.

Most of us would probably have little trouble describing the experience, often with colourful adjectives. Even the definition of pain is fairly easy to understand. A simple definition of pain reads: a symptom of some physical hurt or disorder. Understanding pain, however, is much more difficult.

So let’s start with the easy part. When there is an injury to some part of your body (like when you step on something sharp) it is detected by a group of nerves called nociceptors. Nociceptors are most concentrated in areas prone to injury, such as your fingers and toes. When nociceptors detect an injury, they relay messages along the nerves up to your spinal cord. Your spinal cord then transmits this message directly to your brain. When news of your sore foot travels up the spinal cord, it arrives at the thalamus — a sorting and switching station deep inside your brain. The thalamus forwards the message simultaneously to three specialized regions of the brain: the physical sensation region that identifies and localizes the pain, the emotional feeling region that experiences suffering, and the thinking region that assigns meaning to the pain. Your brain can respond to the pain message by sending a signal back down your leg telling the muscles how to react to decrease the pain. When the pain is intense, this whole process happens before you are even aware of it.

Okay, here’s the part where it gets a bit more complicated. There are cells at each stage along the nerve pathway that can modify the pain signal to increase or decrease the intensity of the signal that gets to your brain. Have you ever banged your hand on something and thought that you were mortally injured, only to discover that there is not even a mark on you?

This is an example of the signal being amplified. Weak signals can be filtered out so that you don’t even notice. Ever find a bruise or a cut that you’re not really sure how you acquired it? That’s probably a good example of filtering.

So, as if that wasn’t complicated enough, your experiences and emotional state can also have a huge impact on how you experience pain. On the other hand, athletes can often condition themselves to endure pain that would incapacitate others.  As can be seen from the brief outline above, treating pain is a tricky business. How someone responds to pain often determines how fast an injury can be rehabilitated. One of the biggest challenges of rehabilitation, is to ensure that clients react appropriately to their pain, and try to make the process of healing as quick as possible.


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