Sunday, January 29, 2017

How to Relieve Pain, Part 1

Part 1: Feeling Pain.

Pain relief is a fairly simple process--that is, it can only be generally done in one of two ways. You can either reduce (or eliminate) the nerve impulse that is "causing" the pain, or you can increase a competing nerve impulse. Unlike other senses like vision or hearing, touch is almost 100% singular in its channeling. In other words, even amidst a flurry of conversations, we can often hear our name when mentioned in a distant conversation without even being explicitly directed towards us. Peripheral vision is perhaps an even more obvious example of being able to sense things beyond our direct focus.

Pain, however, is a purely survival sense. The principle is that you are in pain because some part of your body is in imminent danger of destruction. Pain is supposed to be the signal that causes you to retreat from the source that is causing it.

Interestingly, the automated portion of our brain that deals with pain sense places priority on the area that it believes in the greatest amount of danger based on what we think "hurts most." More interesting, from a scientific perspective, is that beyond the thing that hurts most, our brain barely registers any other pain that might be occurring. It functions kind like that almost clinically-obsessive person who cannot leave his current task unfinished while moving onto another. Pain is not a great juggler. In most cases, this is a great asset.

In my case, for example, I have a tremendously heightened tolerance for "normal" aches and pains. Things that would probably bother me much more are hardly noticeable. OK, the trade-off is that I am in constant pain (aka "relentless agony"), but this actually works to my advantage to let me function somewhat normally. Because the pain from my disorder come from the same area in my body (my chest/upper-abdomen) and is always the worst pain I am feeling, it made it easier for doctors to treat it.

This brings me back to the original focus: how do you relieve pain?

Of course, the answer will depend on what is causing the pain and which part of the body is affected. Although nerves transmit the pain signals, it is rarely the nerves themselves that are the affected area. Damaged tissue is the most common cause... a laceration on the skin or a blunt trauma that breaks a bone or a tear of a ligament... which then triggers a pain signal to race to the brain along a peripheral nerve to the spinal cord and then up to the sensory cortex of the brain. It is rarer, but sometimes, a nerve cell can also be damaged and then trigger the impulse directly. It is commonly believed that nerve pain is the "worst" pain to experience. This phenomenon may be akin to the idea of you getting hurt and then telling a friend to relay your pain to you doctor versus telling the doctor yourself. It also may be that nerve pain tends to take longer to heal.

Next blog: "How to Relieve Pain, Part 2" (On or about Sunday, February 12th)

Saturday, January 14, 2017

Neurocogntive Psychology 101

There are several different types of nerve cells in your body. Some cells are exclusively suited for communication, like telephone wires of olden days. Some specialize in sensation of specific things like reacting to light or sound, and within those specialties there is even more distinction, like retinal nerves that only activate with red light or taste buds that only activate with salty things.

The majority, of course, are actually in your brain and--truth be told--whenever you think you are sensing something like cold or bright or loud, those sensations are almost meaningless out of the context that your brain places them. As is typical in science, the greatest leaps in understanding occur when something goes wrong. The notion of contextual sensation is poignantly obvious with what we call "phantom limb syndrome." Even with an amputated limb, individuals report "feeling" things (often pain) in a limb that is no longer connected to the body. This is particularly difficult to treat since most often, it is the removal of the painful stimulus that results in the greatest relief.

So goes the saying that "it's all in your head." While that is certainly an oversimplification, it is true that the nerve cells in the brain are ultimately slightly more important than the nerves out "in the field" of the body's periphery. If you touch a hot stove, while it is the finger that gets damaged, another nerve delivers that carry that signal to the spinal cord and it's not until the signal reaches the brain that an impulse is generated that goes back to that hand to pull it back from the stove. Of course, all that happens in an instant, but you get the point. So all nerve impulse go through a sensation-perception-reaction process series. Depending on the individual and intensity of the stimulus, voluntary control can be seized before a reaction occurs, like a person who can hold their hand over a flame for a longer-than-normal interval of time.

So how do you help a person in pain, particularly when the source of the painful sensation is idiopathic and/or no longer physically present? The two conditions most baffling to pain management specialists are allodynia and hyperalgesia. The first is a malfunction "somewhere" in the sensation-perception process that causes a non-painful stimulus to be interpreted as pain. The second is a malfunction where a "mild" sensation of pain is perceived as "severe" to "excruciating" pain. Many individuals who need medical treatment for pain have one or both of these conditions.

Next Blog: How to Relieve Pain (to be posted on or about January 29, 2017)

Sunday, January 1, 2017

The start of something new

I've been concerned lately about the terrible way that information is being misrepresented by the press and mainstream media concerning what has been derisively referred to as an "opioid epidemic." Between the deliberate attempts to mislead the public about those who are the cause of this epidemic and the deception about how to remedy the situation, I felt compelled to fight back, even if in this very small way.

In the coming days I will give you my opinion supported by facts for the truth concerning this so-called epidemic and present real solutions. Donations would be appreciated with money to be used to support efforts to reach out to elected officials and help them to better understand the who, what, how, and why of this matter. However, I would prefer that my readers take the opportunity to reach out to their elected representatives themselves wherever and whenever possible. Recognition of the real problem and plausible solutions will ultimately be easier to realize through a collective effort. Even if you are not personally impacted by this issue, I hope that you can empathize with me enough to help in whichever way least impacts your time and resources.