HOW MUCH DOES IT HURT?

Low_back_pain

“I feel your pain” is an expression based on a guess. It is very difficult to know how much pain someone feels

Health providers now offer a scale from 1-10 and ask us to rate our pain. If we are in agony or have an ulterior motive, we may check the 10. It’s a subjective evaluation and sometimes people do lie about their distress—especially if a lawyer is in the picture.

If your pain is a “1” however, maybe we don’t  really need medical attention.

What about a constant ache or pain which is intermittent? Is that a 5 ?

Trying to find a way of determining pain

Scientist through the ages had tried to find out how much we hurt. Now studies are in progress to objectively measure our pains. In the 1990s, researchers started paying attention to nociceptors which are small, thin fibers body in the peripheral nerve system outside the brain and spinal cord. Their job is to register injury to adjacent tissue. During surgery, for instance, nociceptors fire as soon as the scalpel cuts the flesh. They spout chemicals which  induces the nerves to carry the pain message to the brain. (Calandra 2001) .Your brain records a physical memory of the pain even though you might not consciously remember the procedure.

Seeing pain in the brain

Scientists at the University of Colorado have been reporting experiments using a computerized device which creates measurable “burns” on the skins of volunteers. How much pain the subjects are experiencing is at the measured by scanning their brains with functional Magnetic Resonance Imaging, (fMRI.).This is a technique which measures brain activity. It works by detecting the changes in blood oxygenation and flow that occur in response to nerve activity. When a brain area lights up on the scan it represents it is more active and consumes more oxygen.. The premise is that, fMRI protocols can be used to produce activation maps showing which parts of the brain are involved in a particular mental process such as feeling pain.

Tor Wager, Ph.D., an associate professor of psychology and neuroscience at the University of Colorado at Boulder, who led the research which measured pain with the hot plate and the fMRI in a series of four experiments involving 114 adults. The results were published in. the New England Journal of Medicine.(Tor Wager 2013)
Wager says the objective measurements of the amount of pain and the amount of brain activity were 90 to 100 percent accurate.FMRIscan

fMRI Scan

What about emotional pain?

How our brains react to emotional pain depends on personality, and many other factors including gender. So how do you create an objective measure of emotional pain? Again, the Colorado researchers used the fMRI picture brain activity. They tested people who had just broken up with a loved one and were still feeling the results of a heart break. They were shown pictures of their lost love and those of just

North_Korea_-_Woman_soldier_(5381388280) (1)

friends. The researchers compared the brain scans of those of hot plate volunteers with those of the lovelorn volunteers. When the broken-hearted saw the pictures of their lost loves, their brain scans looked “remarkably similar” to those of the hot plate volunteers.

Functional magnetic resonance imaging (fMRI) holds promise for identifying objective measures of pain, but brain measures that are sensitive and specific to physical pain have not yet been identified, Tor says.

Promise and caution of objective pain measurement

Lynn Webster,a founder of  The American Academy of Pain Medicine, praised Tor’s work but said he worries about whether brain scans for pain could create a pitfall:

” Insurance companies might try to use them to avoid paying for pain drugs. Some doctors might use them to question whether their patients are telling the truth. Some may use them instead of simply listening to their patients.

“If a patient believes their doctor understands and cares about them and believes in their pain, which can have as much of a 30 percent reduction in their pain. So that connection, this belief, can be enormously powerful,” Webster says.
Wager agrees that scans should be used very cautiously. “The bad scenario would be you come in pain, the physician scans your brain and says, ‘Well, we don’t see the pain here so we think it’s in your mind’ .. We don’t think it’s really pain,’ ” Wager says.
“I don’t think that this kind of method can or should ever be used as a pain lie detector.”

Instead, Wager hopes the technology will open a helpful window into how pain and other feelings affect the brain.
“There’s no other way to measure emotion besides asking people how they feel,” Wager says. “So the broader hope is that we can take steps toward building a neuroscience of emotion that’s anchored in objective neurophysiological measurements of the brain, as well as reports of emotions.”

“The hope is if we could peer into people’s brains, we could understand that different kinds of pain are created by very different brain systems and we could tailor our treatments to those systems,” Wager says.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s