Pain: physiology and mental health


Written 10 March 2020

Today our prof delved more into how pain works and how arthritis and pain is delt with by doctors. It’s pretty funny how multiple professors of my major all have some sort of gripe about things doctors often do.

I learned pain is cultural: because other cultures than the US do not fear pain, they strive to manage it. Other cultures accept pain, consider it okay, and move forward with things they can do.

US built a sort of culture of pain avoidance and fear of pain. It leads to a cycle of despair about the pain, inaction, and the pain continues.

It’s super interesting how demolition derby has whiplash all the time and the performers are fine, but someone who gets mildly rear ended in a parking lot can suffer through years of pain.

Apparently the emotional response can dictate how much more pain receptors can be made in the area that someone freaks out about from a past injury.

And chronic pain can come from people tough as nails too. It’s not always about if someone is too wimpy to just get over it. It’s weird how doctors can dismiss people’s pain as just “one of those patients” like they’re just acting out. The emotional response to an event/injury or something felt can vary situationally too, not just by person. One can’t really tell how they’ll end up feeling about some things. And that’s really important considering how the body adjusts how sensitive it is.

My professor talked about how there was a cirque performer who has had multiple back surgeries and suffered from chronic pain. After a session of pain education (how it works, how the body changes, the effects of emotion), the woman’s pain eventually reduced by about 70% with pre and post pain test. They checked MRI of her brain lighting up parts associated with pain.

My professor explained that just the awareness that pain is a reaction of the body to protect against a perceived threat helps people immensely, because much of pain is perception. So things can be mind over matter, but simply dismissing people’s pain doesn’t exactly help them as much as it invalidates their experiences.

Placebo is really really cool to me. My prof talked about a study of people with Parkinsons having their medication mixed with their orange juice. Eventually, without informing the people, medication was not mixed in. But after blood tests their blood still had more dopamine in it even though it should be less because of lack of medication. This means the brain, in its belief that the body is getting the meds it needs, itself creates dopamine.

Perception and placebo is just so powerful. Even physiological responses are altered solely on perception.

Really wild to learn that a very good chunk of US gdp is from musculoskeletal issues and that chronic pain is the reason for a lot of visits but many of them are being told the reasons for their pain is because of the imaging showing degeneration when degeneration and pain do not correlate at all.

I had a professor in the past with doctor gripe too. She had chronic back pain, and was told to not move by doctors. Meeting with a physical therapist, she was told to move. Eventually, her pain was gone with movement therapy.

Also, there was a study on ultrasound and pain. One group with the machine plugged in and one without. No difference.

Mental Health

I think if you get trauma once or get an extremely painful memory associated with certain things you can at least imagine how mental pain for a mentally/emotionally vulnerable person can get to the point where it equates having a gash through internal organs and bleeding out if you try a bit.

If you get it once I think if people just tried they can imagine how someone can have multiple traumas and multiple painful memories that just make living painful oftentimes. Especially considering the fact that intensity of pain is affected by how its cause is perceived. Like, even a minor fender bender-related neck pain can become so bad just because the situation elicited fear in the person. Perception affects the physical manifestation of pain.

Knowing how pain works one just needs to try a little bit to be able to imagine how mental pain is as real and as bad as a physical one can be.

Added 2021 January 8:

The point about mental health and pain I really wanted to make was discussed in my other post about mental disorders, down at the section titled “Applying findings on pain to mental disorders.” I forgot this point when I was first writing this article, but still wanted to emphasize a link between pain and mental health. Thus, the above writing on this page was written, which was not really the point I wanted to make.

The point is that chronic pain is a response of the body to protect itself against future damage. Here is a reprint of that section, for this page’s completeness’s sake:

This explains why, in my post, the more emotional distress is associated with an injury, no matter how slight the actual damage may be (e.g. a mild, fender-bender-related neck injury), the more chronic pain is experienced. For the record, my professor is a doctor of physical therapy who studies closely with doctors of neurology who specialize in pain.

Consdering depression can entail chronic emotional pain, it makes sense that depression can be a defensive response the body induced. With pain, the person may be made more aware of the bad situation that induced it. This awareness may bring more caution and prevent further damage to the person. Additionally, this awareness and caution can prevent damage from future similar events.

Added 2020 July 15:

From Not Even Bones, Webtoons.


Image transcription:

You said pain was an emotion. It’s not—it’s a sensory response.

As a bit of an expert on the subject, I can tell you emotions hurt too and some pains are amplified by your thoughts.