Talk:Pain and nociception
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[edit] Invertebrates and Vertebrates
I think there needs to be some information regarding what specific animals feel pain and to what extent. My understanding is that most scientists (and people for that matter) believe most if not all invertebrates are incapable of feeling pain due to their lack of central nervous system and the lack of evolutionary necessity.
I would think that many people would search pain in wikipedia trying to get information on things like insects and pain as well as the issue of boiling live lobsters.
Here are two internet links for some info on the pain in vertebrates/invertebrates debate:
http://www.cbsnews.com/stories/2005/02/14/tech/main673989.shtml http://www.parl.gc.ca/37/2/parlbus/commbus/senate/Com-e/lega-e/witn-e/shelly-e.htm
One is a CBS news story on a study in Norway and the other is the conclusions from a Canadian inquest. U R A GR8 M8 05:00, 23 November 2006 (UTC)
My pharmacology text also specifies Cancer pain, vascular pain and reffered pain and the specification of acute and chronic. I think they should also be included here.
Wrinkleworm 06:37, 5 October 2006 (UTC)
Under 'types of pain' -- I can't figure out why "Neuralgia" links to "Neurasthenia", unless it's because the neuralgia page didn't exist or didn't have much content when the bit about neuralgia was added to this page? I don't think the link to neurasthenia is quite appropriate, and not what I would expect from a link labeled "Neuralgia." But, I don't want to change it if I don't understand why it's this way. (Is there any way to grep through all versions of a page to find where certain text was added or removed??) Also, scales of pain perceived intensity/severity---I know they exist but I didn't see mention of them on the page... ~os~ / User:os
- Agree - need some pain scales; here's a couple links following; the Wong-Baker FACES scale (Pasero C (1997). "Using the Faces scale to assess pain.". Am J Nurs 97 (7): 19-20. PMID 9247377. ) (use of image would require permission [1]); The link http://www.intelihealth.com/IH/ihtIH/WSIHW000/29721/32087.html lists FACES, the very common numerical 0 (no pain) to 10 (worse possible pain), and others. MeekMark 11:14, 19 June 2006 (UTC)
I think somebody should really add a section about pain and pleasure. I'd do it myself, but I don't really think I could do it justice. Especially since I know only a little bit about S&M, from experience. However, I do think that it's a significant subject, and should be examined in detail. The section should look at a) how pain relates to S&M, but not too much, as it is only part of it, and b) The effects of orgasm on the pain threshold.
~Sartas Regem~
EntmootsOfTrolls would have liked this article to be part of User:EntmootsOfTrolls/WikiProject Body, Cognition and Senses, which provides guidelines for articles on those topics, and seeks stronger cross-linkage and cross-cultural treatment of all of these topics.
Given that sense of pain is in fact a sense, this is a central article in that project. The main impact of that project on this article will be to neutralize language and avoid assuming the biomedical model too much. Pain for instance had no link to pain control methods other than drugs, and actually said that biomedical causes exist for pain. That is just not always true, at least not so we can prove. The WikiProject is just about removing this sort of culturally-biased claim, adding mention of other approaches or beliefs from other cultures, and trying to cross-link a lot.
Chronic pain is primarily rooted in biomedical causes, however. The only other option is that it's psychosomatic, which is quite rare. This article shouldn't state beliefs from other cultures unless they are part of a common treatment method used. It should simply be stated that a certain treatment is used without explanation of it as it's not directly relevant to this article. It certainly shouldn't just mention drugs though, there are a variety of other medical treatments available. I'll consider adding some others in like physical therapy, TENS stimulation, accupunctre, bio-feedback/meditation, etc... -Nathan
LOL@picture of Chuck Norris
I've read that chrnoic pain sufferers don't generally become addicted to painkillers, even such as morphine. Then again, it was the opinion of a chronic pain support association of some sort. But there's certainly a large body of chronic pain sufferes who feel they need stronger medication. http://familydoctor.org/handouts/122.html -- "difference between "physical dependence" and "psychological addiction.""
It's true, psychological addiction is rare among chronic pain patients. It's chemical dependency (physical addiction/depdendency) that's common. Keep in mind that chronic pain users are using the medication to treat legitimate pain, which is why it's uncommon to become psychologically addicted. I know many people with chronic pain (myself included) and the idea of using the drugs prescribed for a very serious medical disorder for fun is appaling to them. This is complicated by the fact that if they do get psychologically addicted their doctor will refuse to prescribe them medication, meaning that they would be left with tons of untreated pain (that is a VERY strong deterrant to recreational use). Many people taking the medications don't even get a high/buzz/whatever. In fact, some have very negative reactions to them. -Nathan
Could someone write information about non-human pain: animal pain. The requirements for pain: a nervous system, nociceptors, etc. What is pain's evolutionary significance.
- That seems to be well handled now. And it would be better to write an article on the more objectively observable phenomenon: irritation. We can't say that an oyster feels pain, but we can say it does react to something irritating it, to produce something that is useful to us, and not to it. We can also say that an amoeba avoids a pin we poke it with, but not how much it feels this. Irritation is apparently the only universal sense!
Philosophical issues are interesting, but an article heavily focused on philosphy seems to take an anthrocentric approach. Our linquistically constructed speculations about the meaning of pain might not contribute to knowledge of what we share with other animals as well as might a simple description of the functions of pain mechanisms. The linguistic construction of the bio-medical model has some limitations, but there is probably no reason to omit the perspective of the vast majority of medical practitioners in favor of esoteric philosophical considerations that do not find prominant discussion in any popular venue or professional literature in which the topic of pain is regularly considered. I would rather see philosophy disussed in an article perhaps titled Pain (philosophy), and which more thouroghly surveys historical and perhaps non-Western philosophies of pain. Along those lines, articles would do well to comment on how widely received are esoteric views of pain and pleasure, and by whom they are so accepted and rejected.
My gut reaction in reading this page was that I was being preached at in a persuasive effort to influence my perception of Western culture. I wouldn't mind so much considering esoteric views of pain if the aritcle acurately preached standard taxonomy. The heavy hand of a contributor who wants to spread a non-biomedical approach reminds me of the Church's early campaigns against the development of a standard taxonomy for describing the human body. The church's problem was that such descriptive language tended to weaken the church's authority in declaring the nature of human reality.
Speculative approaches in authoritatarian language also fail to rise to the NPOV standard widely accepted here. The claim that "it (pain) may well be an evolutionary artifact that does us little good any more" leaves Wikipedia speculating against the wisdom of millions of years of evolution. Who is declaring how well it may be? Nobody, as written, beyond the anonymous authority of Wikipedia. It also may well be that the human species would not long survive without the biological tools it inherited from its animal ancestors. (have to say that I agree a simply example would be that withou physical pain, we would'nt notice ourselves being injured at all times and the injury would worsen without care, it's a warning system, and let's face it, it's a dangerous world out there)
Pain most certainly does have direct links to pain control methods, and they start in the brains of most species with the endogenous endorphin system. Historic pain control methods directly exploid chemicals related to the biological pain control system. The discussion of pain and pleasure needs to address some of the more difficult biomechanical issues about the role of endorphins both in pain regulation and in the subjective experience of pleasure. An understanding of endorphin systems can provide a better basis for readers to make their own judgements about esoteric philosophical issues related to law and societies' implicit threat of pain to acheive social compliance. Further, the assertion that pain is a primary tool for social control might exhibit some neurological naivitee. Fear is a different neurological response than pain, and training of fear responses is probably more recognized as the standard tool of social control (beyond Chomskian philosophy).
The article is also short on biomechanical information that could better explain why people suffering pain do not become addicted to opiods. The basic difference between opiod response among those suffering physical pain and all others is that those in physical pain almost always present increased adrenal and cortisol levels, which generally act against the opiods sedating effects, and which dulls the addictive quality of sustained opiod use. SoCal 16:43, 19 Feb 2004 (UTC)
- Also, I am removing the last line that says an ethics of pain will have to recognize something, for several reasons. One is that Wikipedia is not an authority that declares who will have to do what based on any logical construct, no matter how solid. Another is that the language personifies ethic and as written avoids accurately saying homoids who strive to develop an ethic of pain are confronted by various rhetorical and philosophical conflicts and limitations.
- In defense of biomedical physiological language, an accurate understanding of the compassionate capacity built into a brain that allows it to conjecture on the pain of others might provide as much a useful nudge toward understanding the complexities of soldiers perception of others pain as would the firm rhetorical push from a paragraph more about language and philosophy than about the physiology of pain, and the physiological perception of pain. (See Imagery in Healing, Shamanism in Modern Medicine, Shambhala, Boston, 1985) SoCal
These comments make no sense in the context of the page as it now stands. The section on pain and philosophy is now at Pain (philosophy)SoCal 04:49, 20 Feb 2004 (UTC)
This page still needs to be cleaned up but I helped create a clear definition for it so people who are doing research can get some immediate knowledge from it. I also removed the word "modern" as a description of the Gate control theory of pain because this constituted a POV. Also the biological definition has allot of evidence in its favor. Overall its better than nothing. It is also hard to beleive there is no entry for spinal column. hmmmm. GrazingshipIV 03:44, Mar 11, 2004 (UTC)
"However, there is much evidence that pain can retard healing in the hominoid"
How? What evidence?
"Recently, scientific findings show the first evidence that sunlight can affect the perception of pain."
How? What findings?
200.149.25.2 02:19, 4 Apr 2004 (UTC)
This article discusses pain, but doesn't address the root question: what IS pain? In philosophical terms - in fundamental terms - pain ISN'T nerve activity, or sensation, or neural-chemical stimulation. Pain, both psychological and physical, is the fundamental feeling of AVERSION. The essence of pain isn't the sensation. It's the feeling of aversion, dread, dislike, discomfort-- the "not liking the sensation."
What is this quintessential quality of pain-- this "not liking the sensation"? How does it come to be? How CAN it be? What conceivable mechanism could be behind this "not liking the sensation"?
That's the root issue, if you're going to define "what pain is."
[edit] Physiology
There's some incredible work going on now in pain modulation at Stanford, using real-time fMRI technology to enable patients to control their rostral anterior cingulate cortex. Worth exploring to expand and connect the cognitive/biomedical and subjective/mind-body topics in the article.
See http://paincenter.stanford.edu/research/rtfmristudy.html --Ryan Blum 23:28, 24 February 2007 (UTC)
[edit] Pain in Children
I have found this site, and external links discussing the physiological response to pain. I was wondering if anyone had information about the prevelace of acute pain in pediatric patients (particularly in hospital settings). I am running into blocks in my searching. I have found much information about the behavioral perspective, and experential perspecive. Not as much for the pathophysiological perspecive to pain. However since finiding this site I have found a plethora of psyiologial persective to pain. Megankboyce (talk • contribs)
- Those prevalence figures should be available somewhere. It is determined by many variables, but I suspect pain management in children is not as good as it could be. JFW | T@lk 01:20, 30 October 2005 (UTC)
-
- You're right on. I am a medical student who has worked with pedatric pain patients and there are lots of complicating factors. Two big ones being the variable response to analgesic medications (especially among the very young), drugs which are designed and tested almost exclusively on adults; and the subjective nature of reporting pain. Kids can close up, or they can report pain that *seems* unjustified. It's always hard to tell, especially in patients with severe chronic pain. --Ryan Blum 23:17, 24 February 2007 (UTC)
[edit] The conception of pain and also the flora and pain
Last things first. :) Can the flora fell pain (or nociception)? Is there some why it could feel discomfort because of it? It seems to me that it's impossible but we had some discussion recently so it's still a thing to ask.
Next thing - pain is understood by the mind, huh? I mean - if the mind is turned off there would be no pain? But how can then nerves put the pain into thoughts so that even the mind could understand it? Like, I can understand actions and ideas, but how pain? Or more importantly, how does it make the mind feel uncomfortable? The same question would be about the touch, but it does not hurt for the mind - it just gets the information so that it could process it. But how pain?
I hope you understood my points. :)
[edit] Philosophy of pain.
I think there should be at least a short blurb about the philosophy of pain. I'm adding one; however, feel free to remove it if you feel fit. --ILikeThings 11:35, 29 May 2006 (UTC)
the problem is that pain these days signifies any damn emotion or bodily function that causes an undesired "feeling", either physcial or emotional. the article on pain should really only be on physical pain and perhaps pain from "phantom limbs", mental pain, if it indeed can be called that, should be considered a different thing.
Cite error 4; Invalid <ref> tag; refs with no name must have content== Fingernails and Toenails, teeth, and survival pain ==
It seems apparent to me that fingernails and toenails being prone to extreme pain have an obvious (vestigial) survival benefit.
We evolved from animals that defended themselves and hunted primarily with their claws, assumedly, if you go back far enough. Damage to a claw could mean death! Being unable to defend yourself or hunt, sure sounds like bad for survival.
The same is true of teeth. This part of the article seems to assume we always could go down to the grocery store and buy some mushy processed food.
I have no citations, so I'm not changing it, but it seems logical to me. Gigs 03:08, 1 July 2006 (UTC)
[edit] Location of pain
I removed this text (quoted verbatim) from the article, but it seems like a good question...
While pain signals are processed in Brain, what makes you feel that the pain is occuring in a perticular organ or point ? AndrewWTaylor 12:33, 18 July 2006 (UTC)
[edit] Dead link
During several automated bot runs the following external link was found to be unavailable. Please check if the link is in fact down and fix or remove it in that case!
- http://www.pain.remedica.com
- In Palliative care on Sun Jul 16 21:24:00 2006, Socket Error: (-2, 'Name or service not known')
- In Pain on Mon Jul 17 15:19:09 2006, Socket Error: (-2, 'Name or service not known')
- In Palliative care on Mon Jul 17 17:19:26 2006, Socket Error: (-2, 'Name or service not known')
- In Pain on Thu Jul 27 00:46:01 2006, Socket Error: (-2, 'Name or service not known')
maru (talk) contribs 04:46, 27 July 2006 (UTC)
- Thanks Maru ~ apparently this link should've been http://pain.remedica.com/. However, I took the liberty and removed the link anyway. All I found on the site was publication titles, not even short summaries or reviews or any educational material; the site requires everyone to register ("Subscriptions are free for healthcare professionals. Non-healthcare professionals can subscribe at the rates detailed below." / the rates not shown.) Am I missing the obvious? will be glad to be mistaken, but from what I see, I'm taking the link out as it doesn't seem of any particular use. - Introvert • ~ 07:57, 27 July 2006 (UTC)
[edit] Lead para
"Pain is a severely unpleasant feeling" - severely doent always apply. Pain is often slight or mild. "Sensation" is better than "feeling" because pain is ?always felt as a bodily sensation or feeling not purely an emotional feeling. What do you think? SmithBlue 04:46, 30 November 2006 (UTC) I think this article should explain how pain gets to the brain. through sigbals? Which part of the brain are the signals or impulses the pain sensors sent going to? Could Wikipedia have more information on how exactly the brain relates to the pain? Please give me information about that relationship. User:75.40.0.246 1 December 2006
This info is in the sections starting with "Physiology of nociception" - its called nociception cause the signals might not be felt as pain. Pain is something that happens in consciousness. Nociception is not in consciousness. Have added some info on Wikipedia on your talk page. SmithBlue 03:48, 1 December 2006 (UTC)
Bold textLook at entry from The Institute for the Study and Treatment on Pain - iSTOP in www.istop.org. User:154.20.73.202 1 December 2006. Appears to say there are 3 situations of nociception. ? SmithBlue 23:50, 1 December 2006 (UTC)
[edit] Definitions, common usage; pain & nociception
My position is: the paragraph I deleted belongs on the talk page, not in the article itself. Material stating that another part of the article needs to be improved belongs on the talk page. If some words in the article need to be changed from "pain" to "nociception" they can be changed. Some people may not agree with such changes. The word "pain" may be better in some contexts: understood by more people and therefore clearer to most readers. The distinction between "nociception" and "pain" does not have to be brought up every time pain is mentioned. --Coppertwig 23:52, 1 December 2006 (UTC)
- At present, in the article, definitions of pain and nociception are given (or referenced) and then the word "pain" is used in ways contrary to the definitions. The deleted para is not about improvements needed in the article. Its about acknowledging and warning the reader of the contradictions and confusions within the article and subject. I'd like the distinction between "pain" and "nociception" brought up every time the word "pain" is used contrary to its offered definition. Or could add a section on the historical use of the word "pain" within physiological research and explain the confusion and misnaming? Others views? SmithBlue 00:25, 2 December 2006 (UTC)
-
- Alternatives: Change the definition of "pain" given in the introduction, or give more than one alternative definition, so that the way it's used later in the article is not contradictory. I believe this is similar to what you're suggesting. Or, edit the article so there are no contradictory uses of the term. Or, mention here on the talk page which uses you believe are contradictory and why and maybe we can find a solution. We don't have to limit the use of the word "pain" to a specific, restricted definition if it is not the way the word is usually used. There may be other acceptable alternatives I haven't thought of. --Coppertwig 01:07, 2 December 2006 (UTC)
Its "obvious" to a naive human that pain is happening, say, down there at their toe. Initially medicine/science used this assumption as the basis for naming the structures involved in the detection, transmission, types and causes of "pain" ; e.g. pain receptors, pain fibres, cutaneous pain, visceral pain, neck pain, back pain and physical pain. But recently it has become clear that pain, as we experience it, is something totally distinct from most of the preceeding examples. The International Association for the Study of Pain (145,000 google hits), founded by J Bonica (101,000 google hits: pain Bonica) whose scientific staff officer was Patrick Wall of Gate Control Theory of Pain fame, on their [Pain Terminology] page say "Avoid use of terms like pain receptor, pain pathway, etc." Obviousy we are not bound by this. But we need to find a way to be consistent in this article. (Kinda muttering to myself here. No disagreement with ::Alternatives) SmithBlue 02:09, 2 December 2006 (UTC)
- I disagree with the advice "Avoid use of terms like pain receptor, pain pathway, etc." and agree that we are not bound by it. It may be useful under some circumstances to follow that advice. It may be useful under other circumstances not to. --Coppertwig 03:40, 2 December 2006 (UTC)
"Pain, as mentioned above, is usually experienced as having a location within the body. This experience gives rise to terms such as "physical pain" and "back pain". Medical researchers into pain continued with this way of naming dicoveries related to pain and so used terms such as "pain receptor" and "pain fibre". Although now named "nociception", this meaning of the word "pain" is in common usage and is used frequently in this article." Hows this look? At present article is internally inconsistent/misleading. Will be posting above unless another way for consistency is achieved - even if only temporarily. SmithBlue 08:11, 4 December 2006 (UTC)
- I don't understand what you mean by "will be posting above". Please explain. "unless another way for consistency is achieved" -- that sounds as if you are not satisfied with any of the several alternatives I suggested. Please explain reasons for not being satisfied with each one, or mention another alternative, if you're thinking of editing the article in a way different from the ways I suggested, with regard to the definition of "pain". --Coppertwig 14:21, 4 December 2006 (UTC)
Does {"Pain, as stated above, is usually experienced as having a location within the body. This experience gave rise to terms such as "physical pain" and "back pain". Medical researchers into pain continued naming their discoveries as if pain was located in the body and so used terms such as "pain receptor" and "pain fibre". This usage of the word "pain" is common and occurs frequently in this article."} meet your standards for an additional definition of pain? If you have something better please put it in. SmithBlue 15:42, 4 December 2006 (UTC)
- How about this shorter, less POV definition: "In this article, the word 'pain' can refer to what is subjectively experienced, as in 'there is a pain in my foot', or to the action of experiencing it, which occurs only in the brain." (I find the "as if" in yours to be too POV.) --Coppertwig 03:20, 5 December 2006 (UTC)
Brevity! Good. - 1. is subjectively experiencing something either an action or act? 2. how to fit this definition to usage such as "pain receptor" and "pain fibre" - which are not subjective experience but anatomical entities? 3. "occurs only in consciouness"?("brain" seems antimind POV and vague) 4. Also "subjective experience" is the existing definition of pain(vs nociception). To use the same terms for a contrary definition is difficult reading. 5. ""pain" is used as an adjective/noun for ?"much" to do with the location, physiology and treatment of disease/injury resulting in pain." ie p managemnet, p fibres, p pathway, p specialist, p in foot, neck p. This might be another place to work from. Wanna define much? SmithBlue 07:06, 5 December 2006 (UTC)
- 1. The meaning of "action" may be being stretched a bit here, but I think people will understand it. "Event" may be more correct but to me less clear. Or "the action of experiencing it" can be replaced by "the experience itself". Other suggestions? 2. Easy. "pain receptor" means "a receptor which has something to do with pain", etc., according to the standard method in English of using any noun as an adjective. 3. "consciousness" is OK but to me makes the entire pair of definitions harder to understand -- I think more people will end up thinking "what is this trying to say? both these definitions seem to be the same thing." 4. I think what you mean is that "subjective experience" is the definition of nociception, and that using the words "subjective experience" when defining something located in the foot is confusing. I agree it's a little confusing; can you improve it? However, I don't think it's very confusing, because I'm making the distinction between the subjective experience itself, and the thing that is subjectively experienced. The mention of concrete body parts (foot and brain) in the defniitions makes this pretty clear, in my opinion. 5. "pain" is used as an adjective for anything having to do with pain. Thanks for working on improving a Wikipedia article. It's interactions like these that result in good, polished articles. --Coppertwig 14:32, 5 December 2006 (UTC)
4. No: pain is defined at beginning of article as "a subjective experience" (and so not open to direct measurement or comparison.) Nociception is a measurable physiological event. So using "what is subjectively experienced" is confusing. Writing about consciousness is just plain dificult I see now. 5. This looks like it may be an easier beginning for a second definition - no need to write deeply about consciouness or subjective experience. Have asked some experts to help on this but no sign of anyone yet.SmithBlue 15:38, 5 December 2006 (UTC)
- Now you have me confused. What is nociception? --Coppertwig 05:05, 6 December 2006 (UTC)
Nociception is that subsection of the nervous system (and central nervous system) that carries information concerning insult to tissue. It includes receptors, nerve fibres and pathways in the spinal cord and (I think)areas within the brain. The information it delivers is used by the nervous system in many ways: often below the level of conscious awareness - reflex movements away from the point of activation of nociceptor, adjustment of sensitivity of nociception system,... (I dont know what else). And Sometimes the information is passed to the thalamus ( an area in the brain) at which point we first become consciously aware of an nonlocalised Pain. If it then goes to the ?somotosensory cortex the pain becomes localised in our awareness. If this is news to you then I'm fasinated by your ability to recognise the trashiness of my definitions of "pain". Assuming I've got nociception right how do we need to rewrite this article so that an intelligent motivated reader such as yourself can understand what its trying to convey? SmithBlue 16:58, 6 December 2006 (UTC)
- Thank you so much for inviting me back to help edit. Re lack of previous familiarity with the term "nociception": a good person to test a definition is one who has no previous familiarity because such are the target audience. I think I got the two terms "pain" and "nociception" reversed at some point in this discussion. I hope I have them straight now.
The opening section still requires editing. I will make an attempt below. Please comment. Goals: internally consistent; smooth and flowing, pleasant to read; logically organized; spelling and grammar, as well as accuracy. Problems: awkward to read. First paragraph is great, but some of the rest gets bogged down. Link to "nociception" goes to a page listing a bunch of terms but "nociception" is not on the list. Confusing. Does not give the reader a clear idea of what "nociception" is or how it relates to pain.
Question: Can we say that nociception usually or normally results in pain? If not, can we say that nociception, when sufficiently intense or above a certain threshold, usually or normally results in pain? If not, could you explain again what nociception is?
You might want to consider creating a Wiktionary entry for nociception and linking to that, or finding some other, more informative link than the one you gave. (I only saw a list of other words, no info on nociception; did not read the whole page; if the info is there tell me where and I'll read it.)
I'm still not quite happy with the 3rd paragraph below, but here's my version -- what do you think? I have not changed the first paragraph, nor the last two paragraphs.
Pain is an unpleasant sensation, ranging in intensity from slight through severe to indescribable. Pain is experieced as having qualities such as sharp, throbbing, dull, nauseating, burning and shooting.
Pain is a subjective experience -- it occurs only in consciousness, in the mind. The severity and quality of pain is only describable by the person experiencing it. Pain usually results from nociception, (stimulation of specialized nerve receptors and transmitters in the body), when it is sufficiently intense to become consciously noticeable. Pain can also be experienced in response to both external percieved events, e.g. seeing something, or internal cognitive events, e.g. felt tightness in an amputated limb.
Pain often has both a emotional quality and a sensed bodily location. In plain words; you feel bad, and your body hurts somewhere, when you experience pain. This subjective reality of the localisation of pain to an area of the body is the basis for terms and phrases such as neck pain, cutaneous pain, and "pain in my back". Scientifically, nociception is the system which carries information about inflammation, damage or near-damage in tissue to the spinal cord and brain, while the term "pain" is reserved for the subjective experience, something which happens only in consciousness, not in the part of the body where the pain is felt.
Nociception frequently occurs below the level of consciouness without pain being felt. Despite it triggering pain and suffering, nociception is a critical component of the body's defense system. It is part of a rapid warning relay instructing the central nervous system to initiate motor neurons in order to minimize detected physical harm.
Lack of the ability to experience pain, as in the rare condition Congenital insensitivity to pain or Congenital Analgesia, can cause various health problems. The two most common forms of pain reported in the U.S. are headache and back pain. Pain is also a term specifically used to denote a painful uterine contraction occurring in childbirth.
The word "pain" comes from the Latin: poena meaning punishment, a fine, a penalty.
--Coppertwig 14:04, 8 December 2006 (UTC)
Glad to see you here Coppertwig. The temptation is to try and describe what the intro is meant to mean to you. But that, like you say, will not be taking advantage of the present situation. Cn we walk through the current entry (9-12)? If so (and looking at your combining paragraph above - "describable by the person experiencing it. Pain usually results from nociception,") Yes and no - if you are a stuntman then yes pain would ussually arise from nocoception - if you are a teenage drama queen pain would ussually arise from emotional sources. Here I want to check - do you get the vast difference between a physiological event and subjective experince? Physics and chemistry will describe one but the other is totally incomparable, in a very different dimension, it exists verifiably only for the person experincing it and is communicatable only by us assuming that something very similar is happening in the other persons head as well. Is this distinction familar to you? Cause thats a lot of the difference between nociception and pain. When you go to the doctor and say "since that fall I've been in a lot of pain" there is no way the doctor can verify the truthfulness of your claim. She can find out if you have nociception increased from your ?hip. But the pain is wholly in your consciousness and is unverifiable. If you havent "got" this from reading the first two paragraphs then what do we need to do there? (before we move to the next ones) SmithBlue 01:49, 9 December 2006 (UTC)
- Hi. Hmm. "pain usually results from nociception" can mean two things. It can mean that when nociception occurs, pain usually follows. Would you say that is false? It can also mean that when pain occurs, it was usually a result of nociception. I think you're saying that one is false. That may be. Perhaps what I meant to say is more like this: the word "pain" describes something best exemplified by a result of nociception. I'm thinking in terms of radial categories as described by George Lakoff in his book "Women, Fire and Dangerous Things: What Categories Reveal About the Mind." In other words: emotional pain can well be called pain, but when someone is asked to come up with a good example of pain, they'll tend to see pain from nociception as a good example. Emotional pain is not a good example. Calling emotional pain "pain" is almost metaphorical. It's like if you're asked to give an example of a bird and you give a dead bird, or a baby bird, or an egg not yet hatched, or a bird such as an ostrich that can't fly. Well, they are birds. But they're not good examples of birds. A bird is a thing that flies (at least usually). Pain is something you feel when you're physically hurt (at least usually).
OK, here's another try for the 3rd paragraph (after "...only decribable by the person experiencing it.")
" Pain can result from nociception, (stimulation of specialized nerve receptors and transmitters in the body), when it is sufficiently intense to become consciously noticeable. Pain can also be experienced in response to both external perceived events, e.g. seeing something, or internal cognitive events, e.g. feeling tightness in an amputated limb."
You ask: "Here I want to check - do you get the vast difference between a physiological event and subjective experince? " Yes. And I think the phrase "physiological event" is clear. But "subjective experience" has three possible meanings. If I say "I have a pain in my (amputated) foot", we could say the subjective experience happens in the (amputated) foot. (Well, that's at least where it subjectively seems to be happening.) Or we could say it happens in the brain. I don't understand why you don't like to say that; maybe because parts of the spinal cord, nerves in the heart etc. are also involved in doing the sorts of things the brain does? Or we could say it happens in "consciousness" -- that seems to be just possibly getting out of the realm of the scientific. At least three meanings associated with these three locations, I think. So it's a little vague or ambiguous. That may or may not be a problem when trying to figure out what words need to be in the article.
I'm not sure that consciousness is in another dimension or is verifiable only by the person experiencing it. I think maybe when we find better tools for looking at the brain maybe we can see consciousness happening. For example, there was an experiment that looked at the time it takes people to compare two objects and decide whether they're the same or not, and the results seemed to suggest that people rotate a model of the object in their brain at a measurable speed. That could be called a study of consciousness or of an aspect of consciousness. As we advance in artificial intelligence these sorts of things may come under greater scrutiny. Again, this may or may not be a problem when choosing what words to include in the article.
Just because pain is only in our consciousness doesn't necessarily mean it's unverifiable. We could measure results of the pain: insomnia, heightened anxiety evidenced by quicker breathing, and other things could be evidence that the person was experiencing pain.
I think I "got" the distinction between consciousness and a physical event fine from the first two paragraphs, and that one of the problems is that the other paragraphs are boring because they're repeating some of the same information that has already been said. It needs to be snappier to keep the reader's attention. If anything needs to be discussed in detail it can be moved into one of the other sections where the reader is presumably already interested and paying full attention (though that would be happening in consciousness and unverifiable :-) --Coppertwig
Howdy - At present the best scientists and insurance companies can do is find neural events correlating with reported consciousness. Its these scientists who define Pain as a mind event. Health nsurance companies would love (big money) to be able to show whether someone is in pain or not. They cant. So at present, the quality of consciousness is only verififiable by the person experiencing it. Yes a lot of pain follows nociception. But it is in no way a consequence. Emotional pain is pain - ask someone who has just been betrayed by their best friend, lost their spouse in a car crash, Or ask someone who is about to commit suicide - "Why?". Already, like you say, the common thinking of the main cause of pain would be "Physical pain" (a slightly older physiological term for nociception). But this unfortunately just strengthens their thinking that pain is a consequence of nociception and some sort of neural event. (You yourself keep wanting it to be like this and you've read the introduction many times.) But science says no, so far it cant even come up with a widely accepted model of consciouness. Found an article on the hard problem of consciousness [2]
I like your idea of keeping it snappy - I've made a sandbox AlternativeUniverse2 linking from my talk page and will experiment there with more like the first two paragraphs. Will attempt to flow on through without laboring point on consciousness and let it have a section later in article. I suspect this is wrong but I dont know enough - "when it is sufficiently intense to become consciously noticeable." SmithBlue 08:46, 9 December 2006 (UTC)
- You seem to be implying that pain is not a consequence of nociception. I don't follow at all. I thought you were defining nociception as the signals going from damaged body parts (for example) towards the brain and (sometimes) resulting in pain. If that's not it, then tell me again what nociception is. You're really getting me confused. —The preceding unsigned comment was added by Coppertwig (talk • contribs) 03:18, 10 December 2006 (UTC).
Hi Coppertwig - sorry if I'm getting you confused. In terms of cause and consequence , pain is a possible consequence of nociception (I acknowlege this contradicts what I wrote above - apologies) I think "when it is sufficiently intense to become consciously noticeable." is wrong because it may not be the intensity of the nociception that determines whether pain is experienced but rather how consciouness in functioning at the time. But then again consciousness may be able to desensitise nociception so that little nociception is occuring in the brain. In which case you'd be right. Or we could both be right ... Writing this its obvious to me that I dont know enough to edit this article at the moment. I've put together my understanding of a ?easily understandable, internally consistent, Possibly verifiable intro in my sandbox [[3]] but until I've got sources for stated facts I'm not going to develop Pain. Thanks for your edits and contributions over the past weeks - I've learn a lot and will at least have good questions for future editors here. SmithBlue 10:05, 10 December 2006 (UTC)
- Thanks for your collaborative style. My main objection in the beginning was that one part of the article was saying that another part of the article was wrong. When I said something about the nociception being intense enough to be noticed in consciousness, I realized that the threshold would vary based on things like how busy the person was; but I figured that (at least almost always) given the state of the mind there would be a threshold above which the nociception would result in pain. I didn't mention that, in order to keep things simple. By the way, I don't know whether you count headache as emotional pain. I count it as physical pain. I find "pain in my foot" to be a better example than "pain in my back" because the back contains the spinal cord, part of the central nervous system, leading to possible confusion about where the pain is located (i.e. in the body part or in the central nervous system or in consciousness); the foot is the most distant part, maximally reducing this confusion (as well as being a part that occasionally gets stepped on or stubbed. That reminds me of an Ambroise Bierce definition: "Shin: a device for finding furniture in the dark" :-) --Coppertwig 02:38, 12 December 2006 (UTC)
Hi Coppertwig - you are right about "pain in my foot" being less confusing. Changed that. I too think that headaches arise from nociception (physiological pain) and are sensed as "physical pain". (Sorry trying to be overly pedantic and funny - didnt quite work.) I come from a science background and like my definitions to be all encompassing. Even absolute. Which works great for science but not well for other areas. So when I think of a soldier shot in the leg (heaps of nociception happening) who doesnt notice it at all until dismounting and finding an ankle one third missing, I say "no I dont thinks its an amount of nociception" It may well be some sort of threshold of consciousness. But I diont know." However at the moment as long as no-one is claiming that pain is the neural correlate of gravity or caused by Neptune I dont mind. Are you OK with the renaming of the topic to "Pain and nociception" ? - with the conflicting uses it seems impossible to explain pain without teasing out nociception. SmithBlue 03:11, 12 December 2006 (UTC)
[edit] Pain is a subjective experience....
172.200.74.209; (depending on interpretation this statement is either too obvious to be worth mentioning, or probably wrong) "Pain is a subjective experience: it occurs only in consciousness, in the mind. The severity and quality of pain is only describable by the person experiencing it." What interpretations do you have and which is wrong and which trivial? SmithBlue 15:20, 11 December 2006 (UTC)
- This statement is confusing. However, the subjective nature of pain is paramount to understanding it, and we should build on this topic in the article. I'm drawing on my experience as a medical student in pain clinics, especially with children. --Ryan Blum 23:24, 24 February 2007 (UTC)
[edit] nociception (syn. nociperception)
nociception (syn. nociperception, physiological pain) Google; 578,000 for nociception, 6,600 for nociperception, 10,700 for "physiological pain". SmithBlue 23:58, 11 December 2006 (UTC)
[edit] == "can sometimes follow from nociception" ==
I object to the phrase "can sometimes follow from nociception" in the introduction. This statement is highly confusing. It gives the impression that nociception is some rare phenomenon, like the pain felt in amputated limbs. Many readers will not be familiar with the term "nociception". My understanding is that "nociception" is actually the usual mechanism causing ordinary pain (as opposed to emotional pain). The phrase "can sometimes follow from nociception" is a massive understatement (unless nociception actually is some rare phenomenon. I'd like to see a definition of nociception.)
Please do not edit the opening section of this article in ways that go against what any editor is expressing here while discussion is in progress.
Does anyone particularly like the "can sometimes follow from nociception" bit? If so, we can look for wording that satisfies both. Please state clearly that you like that phrase and why. If no one speaks up I'll edit it out. --Coppertwig 14:11, 12 December 2006 (UTC)
Actually, unless someone can supply a reference to a definition of "nociception" in an authoritative source, I would like to edit that word out of the article completely. --Coppertwig 14:13, 12 December 2006 (UTC)
from http://sulcus.berkeley.edu/mcb/165_001/papers/manuscripts/_804.html "Nociception, itself, is comprised of four basic processes .... The first process is known as transduction and involves the translation of noxious stimuli into electrical activity at sensory endings of nerves. ... The second and third processes are known as transmission and modulation and can be considered simultaneously. Transmission involves activation of peripheral receptors with subsequent depolarization of their axons. It is these axons that relay information to their cell bodies in the dorsal root ganglion .... Modulation involves the modification of nociceptive transmission at the level of the spinal cord. Nociceptive fibers enter the spinal cord through Lissauer's tract,..... The dorsal horn, itself, is a processing center for information and is made up of many distinct layers of neurons with varying morphology and function. The dorsal horn basically serves as a "complex neuronal switching station" that filters, attenuates, and amplifies sensory input before relaying this information to other spinal segments ...."
Section B 2. from NP(Nurse Practioner)Central http://www.npcentral.net/ce/pain/section1.shtml states "Nociception refers to the process by which information about tissue damage is conveyed to the central nervous system (CNS)." SmithBlue 16:13, 12 December 2006 (UTC)
Hi Coppertwig - thought this Pain definition seemed very concise "International Association for the Study of Pain is as follows: "An unpleasant sensory and emotional experience normally associated with tissue damage or described in terms of such damage." and then "Pain is whatever the experiencing person says it is, and exists whenever he says it does."(via - http://www.sign.ac.uk/guidelines/fulltext/44/references.html#3 - McCaffery M. Nursing management of the patient in pain. Philadelphia, Pa: JB Lippincott 1972.) SmithBlue 07:11, 13 December 2006 (UTC)SmithBlue 07:24, 13 December 2006 (UTC)
Hi. OK, well, we sort-of have a definition of nociception but not really. That web page you gave says "Term Paper". That gives the impression that it's an essay someone did for their homework. We need an authoritative definition. What about that International Association for the Study of Pain? They define "nociceptor" but not "nociception" as far as I can see. It would be good to provide a link, in the article, to an authoritative definition of nociception. (I tried a dictionary and again got a related term but not that particular term.) However, I won't insist on deleting the word from the article.
Aha! "normally associated with tissue damage" -- that's what I was trying to get at. The phrase "pain usually follows from nociception" is ambiguous. It could mean "whenever pain happens, there was usually nociception involved". That's what I meant. But you interpreted it as "whenever nociception happens, there's usually pain involved." which is quite different and not what I was trying to claim. We just have to find the right wording.
I would also like to delete this sentence: "This usage of "pain" is often inconsistent with pain being a subjective experience and occurs frequently in much communication on this subject and contrasts to the definition given below." This seems to be claiming that it's wrong to say "foot pain". But you've provided a quote saying "Pain is whatever the experiencing person says it is", and anyway, people aren't going to stop saying "foot pain". I don't consider it wrong. I disagree with the assertion "This usage of "pain" is often inconsistent with pain being a subjective experience." I don't think that's true. A person can be well aware of pain being a subjective experience and still say "foot pain" or "pain receptor". --Coppertwig 02:25, 15 December 2006 (UTC)
Hi Coppertwig - didnt see "term paper". What did you think of the Nurse Practitioner Central definition of nociception? Section B 2. http://www.npcentral.net/ce/pain/section1.shtml Yes the way the IASP puts it is very inclusive of all pain. It makes my atttempts about" inconsistent etc" irrelevant for the intro. Delete them please. The IASP had a panel of experts working for some time to come up with their definition. At least we have the good sense to recognise its value.By including ""Pain is whatever the experiencing person says it is, and exists whenever he says it does." McCafferey"" we'd have the subjective experience POV confirmed with a cited source. SmithBlue 03:32, 15 December 2006 (UTC)
- I think the IASP definition is ideal for intro. Read no further if intro is your focus. Found info on research into nociception - "Feinstein and colleagues injected lateral interspinous process tissues with hypertonic saline and mapped out local and referred pain patterns." BUT "Certain subjects who were injected with hypertonic saline complained little of pain, and instead,... "were overwhelmed by a distressing complex of symptoms." These patients suffered with pallor, sweating, bradycardia, a drop in blood pressure, subjective "faintness," nausea and syncope. ... these visceral manifestations "were not proportional to the severity of or to the extent of pain radiation; on the contrary, they seemed to dominate the experience of subjects who complained of little pain." ..."this is an example of the ability of deep noxious stimulation to activate generalized autonomie responses independently of the relay of pain to conscious levels." ...In short, we need to appreciate that we are not all wired in the same neurological pattern. One thing is for sure: It is an extraordinary mistake to equate nociception with pain. Nociception is not pain. Nociception is the reception of a noxious stimulus, and this can lead to the experience of local pain, referred pain, or visceral symptoms." citation seen at http://findarticles.com/p/articles/mi_qa3987/is_200603/ai_n16117205/pg_2 SmithBlue 10:49, 20 December 2006 (UTC)
- "Nociception is the term introduced almost 100 years ago by the great physiologist Sherrington (1906) to make clear the distinction between detection of a noxious event or a potentially harmful event and the psychological and other responses to it."
"Assessing Pain and Distress: A Veterinary Behaviorist's Perspective by Kathryn Bayne" in "Definition of Pain and Distress and Reporting Requirements for Laboratory Animals: Proceedings of the Workshop Held June 22, 2000 (2000)" pg 23 (http://fermat.nap.edu/books/0309072913/html/23.html) SmithBlue 11:09, 20 December 2006 (UTC)
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- I'm happy with the intro as it reads now. Thanks everyone for collaborating. --Coppertwig 14:22, 6 January 2007 (UTC)
[edit] Disambiguation
Now that the article is Pain and nociception rather than just pain, I've noticed that it doesn't seem possible to get to the Pain disambiguation page, but am not sure of what would be the best way to go about fixing this, thanks, Shad3z 11:01, 19 December 2006 (UTC)
- OK, someone has fixed this with an otheruses template at the top of the article with a link to the disambiguation page. --Coppertwig 17:51, 6 January 2007 (UTC)
[edit] Pain as a weapon/punishment
Though this article covers a wide range of material, I still feel this area should be included as well. Use of pain as some sort of a threat or punishment as in severe cases such as torture, beatings etc, or less severe cases, such as smacking, should be covered. I also would like to see some small mention of sadism/masochism, though it doesn't exactly fit in well with these other ideas, so may require a small section of its own. Richard001 04:13, 15 January 2007 (UTC)
[edit] Quick review of article
Since I've just read the article and given it a quality rating, I thought I'd post some comments on what I feel it needs to become A-class.
- Though the POV is pretty minimal in the article, some areas (mainly at the beginning) have a few comments that seem more like the opinion of the editor than a neutral discussion of the topic. If opinions are to be inserted in the article it would be a lot better to have a citation with them.
- Missing or improperly formatted citations (this is quite a problem at the present time).
- One of my main concerns was the article's appearance - quite easy to fix, but it looks rather messy at the moment. This includes spelling mistakes, many red links, poorly structured paragraphs, overuse of boldface etc.
- A few minor areas not covered or not in enough detail. Some areas to add or expand include
- Use of pain as a tool (e.g. torture)
- Communication of pain (e.g. in animal language)
- Perhaps a little more on the philosophy of pain (e.g. multiple realizability)
- More on the evolution of pain (tying in with survival and pain in other species)
- More on pain in non-human animals (e.g. a survey of the history of human attitudes toward animal feelings (e.g. Descartes theory) and a mention of animal rights and related laws today).
- Finally (though fairly trivially) a few images would be nice :)
Overall it's a good article which still needs a bit more work. Given the scope of the subject and length of the article its clear a lot of work has been put into it by its editors. It would be great to see the remaining problems ironed out and have this important topic reach GA or even FA-class. Richard001 05:17, 15 January 2007 (UTC)
[edit] Pain and alternative medicine
In the 'Pain and alternative medicine' Section it is claimed that in the traditonal Chinese medicine pain is viewed 'as "stagnation of blood" - theorized as dehydration inhibiting metabolism.' Could a citation for the second part of this claim be provided?
[edit] Assistance needed
I have run across the article dolorimeter, about devices for measuring pain. Does anyone want to help? It is in sort of sad shape. And I need good reference materials/reviews to work from.--Filll 16:26, 24 January 2007 (UTC)
[edit] Heartache
Is it pain too? And what makes heartache inside a human unit? That s what I m missing a little bit outside there in the article. ff JaHn 20:53, 1 February 2007 (UTC)
- See Broken heart, Psychological pain, and Suffering. I am trying, within this encyclopedia, to straighten out the ambiguous or conflated or entangled meanings of the words pain and suffering. That is a long-term task that I am just beginning, taking as a basis the definition of suffering that is used in the article Suffering and that of pain in Pain. From there, corrections would have to be made in broken heart, psychological pain, and a host of other articles. Robert Daoust 23:34, 1 February 2007 (UTC)
Robert Daoust, I am glad someone else will try. I came and found many islands of articles on pain, but very few connections between them. I tried to establish a few crosslinks, but I am pretty sure I did not do a very good job and I did not do a complete job either. I am not a specialist in pain or medicine. If you have any background in pain and medicine, I would love your assistance at dol and dolorimeter and pain scales. I think there is a lot more that can be done.--Filll 00:29, 2 February 2007 (UTC)
- Your contributions about pain in Wikipedia look great to me, Fill. I would be happy to collaborate with you. Pain however is not my specialty, pain measurement even less. My specialty is the topic of suffering. Since pain is a major kind of suffering though, I have spent much time studying it : hopefully, I'll be useful... Robert Daoust 16:52, 3 February 2007 (UTC)
