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Home > What are the Four Ways that Pain is Processed in the Brain and Body?

What are the Four Ways that Pain is Processed in the Brain and Body?

Jenny Andrus

Jenny L. F. Andrus, MD 

As an Interventional Pain Management Physician, it is important that I intimately understand how the human body reacts to painful triggers, how the nerves communicate with one another and relay those signals of discomfort to the brain. By doing so, I can best tailor treatment for my patients who suffer with chronic pain.

It’s truly amazing that in a split second, you can touch a hot stove burner and feel pain in your finger, and through a complex network of chemical synapses between nerves, the spinal cord and the brain, you jerk your hand away from that stove burner before doing major damage to your body.  As you run your toasted fingertip under cool water to ease the burn, you may not appreciate these processes, but they are at work 24/7.  Let’s walk through them together.

Transduction – a tissue harming trigger activates nerve endings at the site of an injury or illness – our imaginary scenario above where you touch the hot stove burner, setting into motion a process of getting this painful sensory information transmitted to your brain.

Transmission – This is a secondary process whereby the nerves have relayed the message from the origin of injury to the brain area that is responsible for the perception of pain.  As I mentioned above, this happens in a nano-second, so that our brain tells our body that we are experiencing pain almost simultaneously to the experience.

Modulation – is a fascinating and newly discovered neurological process that specifically lessens activity in the transmission system and our potential response to the pain. Without the modulation process, we might feel the burning pain from the hot stove burner, and instead of simply jerking our hand away from the burner and quickly running our finger under cool water, we might instead run away from the stove screaming and jump out of a window.  Maybe that is an extreme example, but it shows how the brain modulates and regulates our response to the painful stimulus appropriately. 

Perception – Last, but certainly, not least, are our feelings about the incident which are created by our senses and our subjective functions, such as interpretation and expectation. How we perceive our experience of pain, what caused it and how our brain interprets each “pain activity” adds to our personal pain library of experiences. All of this impacts our future responses to pain.

Did our experience with the hot stove burner result in 1) a tiny red mark on our finger that went away in a day or 2) in a nasty second degree burn with a huge blister that got painfully infected, needed antibiotics and took weeks to heal?  Obviously, two very different scenarios will cause different perceptions of a painful event, but these perceptions can stick with us for a lifetime and color our pain experiences for years to come.

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