The puzzle of pain

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The puzzle of pain
THE PUZZLE OF PAIN
Despite all this knowledge, we are left with the conclusion of what a great puzzle pain is. Physicians too readily claim that pain is a reaction of defence — a fortunate circumstance which puts us on our guard against the risk of disease. There is a variable link between pain and injury. It is widely believed that pain is always the result of physical damage and that the intensity of the pain is proportional to the severity of the injury.
In general, the relationship between injury and pain holds true — a pinch of a finger produces mild pain while a door slammed on it is excruciating! But there are many instances where the relationship fails to hold up. For example, about 65 per cent of soldiers who are severely wounded in battle and 20 per cent of civilians who undergo major surgery report feeling little or no pain for hours, even days, after the injury.
In contrast, no apparent injury can be detected in about 70 per cent of people who suffer from chronic low back pain. The importance of pain for mankind's survival becomes clear when we consider what happens to people insensitive to pain. They learn with difficulty to avoid damaging themselves severely. But they survive because they develop a language to communicate a problem. Many of them sustain extensive burns, bruises and lacerations during childhood. These injuries ultimately lead to the loss of limbs or joint function simply because they have no pain defence to injury or accident. It has long been known that if the nerves in a joint are missing, or defective, a condition develops in which the joint surface is damaged and the ligaments and other tissues are stretched. This particularly happens to joints such as ankles, knees, wrists and elbows. But there is still a puzzle. Even with normal people, injuries sometimes occur without pain. How is it that a finger can be chopped off in an accident and no pain is felt? Those who have experienced the passing of a kidney stone describe it as painful beyond any expectation that pain could be so intense. Similarly, there is the pain after the healing of an injury.
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