The unique experience of pain

This post is also available in Dutch.

While cooking a meal you get distracted, and before you know it you’ve burned your finger on a hot pan. You drop everything and take immediate action: you pull away your hand!

This reflects a typical pain incident – an intense and unpleasant experience. One that urges us to act and escape whatever is causing the pain.

The multidimensional nature of pain: What happens in your brain when you accidentally hammer your finger. Illustrated by Roselyne Chauvin

As soon as a painful event takes place a signal is sent, which ultimately arrives in the brain. Here the signal is processed in a network of brain areas that together form a particular pain experience. This experience can vary greatly from person to person, and from one occasion to another. It is influenced by many factors, such as our environment, personality, emotional state, and how we attend to pain.

Pain and the role of attention
We constantly receive a huge amount of information about our environment, just think of all the things we simultaneously see, hear and feel. It is impossible to process all of this incoming information in detail. Instead we use attention to select the information that is most relevant to our current goals. Attention acts similarly to a filter.

Let’s now consider attention when we experience pain. Pain is an alarm, it warns us about potential threats and it grabs our attention. Given this alarm, our attention system then makes sure that ongoing activities are interrupted and we immediately respond to the painful and potentially dangerous event. We use our attention to make sure we protect ourselves from any further injury.

How attention can change our pain experience
Attention also plays a role in how we experience pain. How we attend to pain impacts how much pain we feel. When people are asked to focus their attention to the pain, they tend to report higher pain intensity. If people are distracted by focusing on another task, they tend to report lower pain intensity.

When does attention start to influence pain?
Attention is important not only while we feel pain, but also in the period before pain has started. This allows us to anticipate pain using warnings (of potential pain) in our environment and primes us to take action before the start of the pain. In this way we might prevent, or at least reduce, pain and injury altogether.

Interestingly, our pain experience can also be affected by this anticipation period before pain. For example, given the same painful stimulation, we will report higher pain if we expected a highly painful event than when we expected a mildly painful event. Moreover, the brain activation during this period of anticipation has been linked to how much pain we experience. This suggests that our brain can already influence the amount of pain we are going to feel before the pain has even started!

This could potentially offer an interesting area to focus on for the developing effective (non-pharmacological) interventions for pain; Interventions that can help us with how we attend to pain.

For an interesting talk on chronic pain, click here

Laura Arendsen is a PhD candidate in the Cognitive Neuroimaging Group at the University of Leeds. Her research focuses on the influence of expectation on the experience of pain, and how this is reflected in changes in brain activation during the expectation of pain.

Edited by Nietzsche.

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