The Science of Pain

While the clinical facet of pain is very important, I have also been fascinated by the philosophical and scientific questions surrounding pain. Why do we have pain? How is pain adaptive? How does pain shape who we are? How and why do disease states transform pain from an adaptive response to a maladaptive one? How does the brain and nervous system change when someone has chronic pain? How and why does taking too much pain medication end up worsening pain? This question refers to medication overuse headache where headache treatments used inappropriately start triggering headaches as well as how opiates can cause hyperalgesia and heighten pain experiences. What is the relationship between pain and identity? Is there a way to objectively measure someone's pain experience? Is childbirth really "the worst pain most women experience" and how do you prove that? Why do different types of pain feel different; why do some things feel like an electrical shock, burning, ache, pressure, or stab?

Even though most of these questions aren't directly related to medicine, I'm really curious about them. I used to think of pain as a very simple system, but the more I delve in, the more complexity I find. It's not as simple as giving an opiate and blocking signal transmission. From capsaicin (what makes spicy things spicy) to cognitive-behavioral therapy, there are so many ways of intervening with the pain experience that work on chemicals, receptors, neurons, networks, systems, and behaviors. There is so much we don't know, and much we're only beginning to uncover. Philosophers and scientists have been struggling with these core questions for centuries, and I can see now why they are so captivating.