PARADIGMS AND PERSPECTIVES OF PAIN


How Science, Acupuncture and belief systems do pain 

It seems like a rather simple observation. Whenever you injure yourself, you probably shout out some type of expletive related to a word that was meant for more holy or faith driven practices. But….it hurts!

Emotions well up from deep inside of you, you might feel the need to find the closest object to you that can be lifted, with the intention of showing it who’s really in control of this situation. Pain and anger can seem to be intermingled and inter related to each other can’t they? And in certain Bhuddist meditative traditions, Anger IS pain.

In Vipassana meditation the emotion of anger can be observed as sharp or stabbing. And people that are angry sometimes do indeed have pain and feel crappy (which can be explained from Chinese Medicine Theory) and many times when people feel angry they want to lash out and cause that pain to someone else. Maybe so the other person can know what they are going through?

So, it seems that pain and anger can be 2 x sides of the same coin.

From a scientific standpoint, pain is more complex. Involving physiological theories and mechanisms based around receptors, the nervous system and its connection with the brain.

Science doesn’t understand fully what the mechanism for pain is. As it stands, pain is just a theory and science tries to explain it through it’s understanding of physiology and how the mind and body interact with each other. And that’s not a bad thing, because we have learnt a great deal about pain so far.

We understand that there are certain types of peripheral nerve receptors at the place where you   hurt yourself. And science has given us the names of both proprioceptors (position receptors) and nociceptors (pain receptors). Science tells us that these 2 x receptors are important in both the location and intensity of pain. And then science has identified axons, both myelinated and unmyelinated, which serve to propagate action potentials from these sites of positions and pain nerves, to the spine and up to the brain, at different speeds.

Then there’s this cool thing called the homunculus. It’s basically a representation and image of how the brain sees the body.

It shows exactly where each part of the body is in the brain, or where the neural circuits related to a particular part of the body are mapped into the brain. So when you stub your toe, the proprioceptor has signalled the position, then the nociceptor indicates the intensity of the stubbing, identifies it as a 10/10, and so you scream “butterflies!”.

If you slow down what happened there, in a millisecond, the proprioceptors and nociceptors have transmitted a nerve impulse, to the axons, which propagate upward (proximal) through ascending tracts, to the lumbar spinal region, into the spine, up the spinal cord to the neck, where it discusses to the OPPOSITE side of the brain, to the homunculus map to where the evaluating part of the mind reacts. It might then stir up the sympathetic nervous system and emotional centres of the brain, like the amygdala (the emotion centres of the brain).

But, let’s put science aside for a moment and ask, what type of pain is it? Seems like a silly question to ask someone that has just stubbed there toe, because to them the moment is tormented with pain, anger, frustration, or the feeling of wanting to cry. But given the idea that pain is identified by nerves that locate the area involved and other nerves that indicate the nature or intensity of that pain, can we break pain down into it’s nature?

For example, what happens if we ask “what is the pain level out of 10?”.

We are breaking down the pain into an observable and ratable sensation, in a way detaching yourself from the emotional aspect to try and observe how bad it is, how tolerable it is and evaluate your current thresholds for pain.

What if we ask another question: “Is it sharp or stabbing?”.

Now we are starting to identify both the level of the pain and the nature of the pain. Identifying the nature of the pain does several things. It gives us more information about what’s causing it, and also gives analysis the pain as a type of sensation that the mind and body is observing. In Buddhist Vipassana traditions, every sensation has one irrefutable truth. 

Everything is CONSTANTLY CHANGING.

But in Chinese Medicine and Acupuncture, these questions are used to identify the nature or cause, so identifying a sharp pain, means that the cause and treatment is different then if someone has a constant, dull or achy pain.

Interestingly, science has had similar ideas to the Buddhist philosphies of pain.

The similarities are that often science sees pain as just a mirage of the mind, or pain that is really in the mind. Many people have heard of phantom limb pain! And In bhuddist vipassana practices, pain is just sensation which can be felt and evaluated by the mind as “good” or “bad”. So in that sense, it’s just in the mind!

And likewise, the saying is that if the evaluating or reacting part of the mind identifies a particular sensation as painful, a bad thing, instead of just observing it’s truth of always changing, means the reaction of the mind might be to magnify things. 

Chinese Medicine on the other hand makes use of the nature of painful sensations to identify how to manage it. For example, knowing the location of the pain is important in assessing the correct channel or pathway to use in the treatment of that pain (more on pain and it’s effect on ROM here). Knowing the nature of the pain, whether it’s achy or sharp, tells us which areas of the body we might need to use, or what types of herbs to prescribe for better treatment outcomes.

Pain can have cultural, religious, medical, physiological and cross-species inter-relationships, however one thing is for sure. Pain seems dependent on the person or thing observing it. Because it’s hard to empathise with someone that’s in pain if you are not. It’s hard to feel and know what they are truly experiencing. and even if you have experienced the same injury,  people experience pain in different ways, and have been taught to cope with pain in different ways.

For example, if 10 x people experienced the exact same injury, in exactly the same spot on the body, at exactly the same time, each of them might observe the severity, nature, intensity and circumstances of pain differently. They might use different words to describe it, and each body might respond in slightly different ways, physically and emotionally.

The interesting thing about Chinese Medicine is that the system has woven within it all the facets that deal with both the pain component and the emotional component. Each meridian or channel in Acupuncture belongs to an organ network, and each organ in Chinese Medicine theory has an emotion associated. For example, the most obvious one is the heart, which is associated with joy. The Kidneys are associated with fear. So the system has the ability to understand which channel should be chosen to focus on the pain or emotional element. In some cases, one channel might be used to focus on both of those aspects at the very same time.

In considering all these different aspects about how pain is perceived in different paradigms, we can see that there are some overlaps and differences, which can be used to better understand how to deal with and help people that are experiencing pain. If pain really is only a sensation and every sensation is constantly changing, what does that mean about how we deal with it?

If there are modalities that have a framework of how to understand pain in different ways, how can we leverage it’s knowledge and bring it to work together with scientific perspectives? 

Science, chinese medicine, Acupuncture and other modalities are ever-evolving paradigms that are essentially trying to help people find balance, understand and manage their health issues and learn more about their own bodies.

Everyone learns on the path to emotional well being free from pain.

Chad Wuest – Acupuncture Hobart – Chinese Medicine Acupuncturist

Click here for Acupuncture Hobart Bookings.

References:

https://www.sciencedirect.com/science/article/pii/S2256208713000850 – Phantom Limb Pain

https://www.dhamma.org/en/index – Vipassana

https://www.sciencemag.org/news/2016/01/consciousness-may-be-product-carefully-balanced-chaos – Image Credit

https://www.ebmconsult.com/articles/homunculus-sensory-motor-cortex – Homunculus

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