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How does the body feel pain?

Our understanding of how we feel pain and what it means has changed throughout history, and in the past fifty or so years our knowledge about pain has increased hugely.

In history, for instance, Plato felt that pain is an emotional response in the soul which was located in the heart.  Aristotle felt that the brain had no direct function in sensory processes and Hippocrates believed that pain was a consequence of excesses in the flow of one of the four fluids or humours (blood, phlegm, yellow bile or black bile).  In the Middle Ages pain was thought to be a punishment from God.

In the past pain was considered to be a directly wired sensation, as shown in this illustration from the work of Descartes:

image of boy with fire

There is a strong interplay of mind and body in the sensation of pain - many people, for instance, are aware of the fact that in some circumstances painful procedures can be well tolerated under hypnosis, and we have all experienced the way that when we are distracted our pain can be less.  Equally, we have experienced from our ability to "rub it better" that other physical things we do can affect pain.

It is now known that pain and the associated changes in the body and mind and its function and interaction with the environment is very complex. 

One very influential piece of thinking, by Ronald Melzack and Patrick Wall, produced the Gate Control Theory of Pain which is very helpful in pulling all these factors together.

Another very useful model in understanding pain is known as the Biopsychosocial Model of Pain.  There are other factors involved, including the tendency of the nervous system to develop central sensitisation - "jumpiness".

Pain can occur as a result of a number of different mechanisms - see Sources and types of pain

The physical sensation of pain is felt in the brain.  It may be helpful to think about how the pain sensations travel from the part of us that hurts to the brain.  This "wiring" is discussed on the Pain Pathways page.

 

 

 

 

 

 

 

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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
email: pain.webmaster[at]glos.nhs.uk

Page updated 15/02/2016