Physiology of Pain

Pain is described as a “unpleasant sensory and emotional experience.” It is influenced by biological, psychological, and social factors that together form our perception of pain and its intensity. Therefore, pain is not just the detection of something noxious on the body. Each individual’s response to a stimulation is affected by previous experience, cultural habits, and even his or her psychology.  The perception of pain is founded on the complex integration of physiologic signaling between the nerve endings in our skin or organs and our central nervous system. Most people remember learning about the reflex arc in the spinal cord in high school science class. When we touch a hot stove, the nerve endings in our finger (as part of the peripheral nervous system) sends a rapid signal to the spinal cord. Inside the spinal cord (the dorsal horn that integrates sensory signals), a neuron detects the painful stimulation and fires a muscle group that reflexively draws our finger back from the hot stove.

  • There are peripheral nerve endings throughout our entire skin, although some body parts such as our hands and feet, are more sensitive than other body parts such as our back. These nerve endings send signals to our spinal cord, which then sends the signal further upward to the brain to constantly to detect sensation, and also pain. 
  • Just as the spinal cord sends signals up to the brain, the brain can send signals downward that can decrease the perception of pain. That is why an individual may notice that a painful stimulation gets less noticeable after a few repetitions (stretching a sore muscle, tweezing a hair)
  • Research shows that pain and the fear of continued pain can result in significant impairment across domains: employment, social relationships, emotional functioning, physical activity, hobbies, sexual functioning, and activities of daily living.
  • A common response to pain is bedrest and withdrawal from social or physical activities. Unfortunately, this frequently worsens the pain, and the longer the period of inactivity, the harder the pain can be to treat. 
  • Chronic pain can both lead to and be triggered by trauma, depression, anxiety, and toxic stress.

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