Pain and painful sensations. Formation of a feeling of pain, why a person feels pain Why a person feels pain

We feel pain every day. It controls our behavior, shapes our habits and helps us survive. Thanks to pain, we put on a cast on time, take sick leave, pull our hand away from a hot iron, are afraid of dentists, run away from a wasp, sympathize with the characters in the movie “Saw” and avoid a gang of hooligans.

Fish are the first organisms on Earth to feel pain. Living beings evolved, became more and more complex, and so did their way of life. And to warn them of danger, a simple survival mechanism appeared - pain.

Why do we feel pain?

Our body consists of a huge number of cells. In order for them to interact, there are special proteins in the cell membrane - ion channels. With their help, a cell exchanges ions with another cell and comes into contact with the external environment. Solutions inside cells are rich in potassium but poor in sodium. Certain concentrations of these ions are maintained by the sodium-potassium pump, which pumps excess sodium ions out of the cell and replaces them with potassium.

The potassium-sodium pumps are so important that half of the food eaten and about a third of the oxygen inhaled goes towards providing them with energy.

Ion channels are the real gateways of the senses, thanks to which we can feel heat and cold, the scent of roses and the taste of our favorite dish, and also experience pain.

When something acts on the cell membrane, the structure of the sodium channel is deformed and it opens. Due to changes in the ionic composition, electrical impulses arise that spread throughout the nerve cells. Neurons consist of a cell body, dendrites and an axon - the longest process along which the impulse moves. At the end of the axon there are vesicles with a neurotransmitter - a chemical substance involved in the transmission of this impulse from a nerve cell to a muscle or to another nerve cell. For example, acetylcholine transmits a signal from a nerve to a muscle, and between neurons in the brain there are many other mediators, such as glutamate and the “happy hormone” serotonin.

Cutting your finger while preparing a salad has happened to almost everyone. But you don’t continue cutting your finger, but pull your hand away. This happens because the nerve impulse runs along neurons from sensitive cells, pain detectors, to the spinal cord, where the motor nerve transmits the command to the muscles: remove your hand! Now you have covered your finger with a bandage, but you still feel pain: ion channels and neurotransmitters send signals to the brain. The pain signal passes through the thalamus, hypothalamus, reticular formation, parts of the midbrain and medulla oblongata.

Finally, the pain reaches its destination - the sensitive areas of the cerebral cortex, where we are fully aware of it.

Life without pain

Life without pain is the dream of many people: no suffering, no fear. This is quite real, and among us there are people who do not feel pain. For example, Steven Peet was born in the USA in 1981, and when he started teething, he began to chew his tongue. Fortunately, his parents noticed this in time and took the boy to the hospital. There they were told that Stephen had a congenital insensitivity to pain. Soon after, Steve's brother Christopher was born, and the same thing was discovered in him.

Mom always told the boys: infection is a silent killer. Without knowing pain, they could not see the symptoms of diseases in themselves. Frequent medical examinations were necessary. Having no idea what pain was, the guys could fight to the death or, having received an open fracture, hobble around with a protruding bone without even noticing it.

Once, while working with a power saw, Steve cut his arm from hand to elbow, but he sewed it up himself, being too lazy to go to the doctor.

“We often missed school because we ended up in a hospital bed with another injury. We spent more than one Christmas morning and birthday there,” says Stephen. A life without pain is not a life without suffering. Steve has severe arthritis and a bad knee - this threatens him with amputation. His younger brother Chris committed suicide after learning he might end up in a wheelchair.

It turns out that the brothers have a defect in the SCN9A gene, which encodes the Nav1.7 protein, a sodium channel involved in the perception of pain. Such people distinguish cold from hot and feel touch, but the pain signal does not pass through. This sensational news was published in the journal Nature in 2006. Scientists discovered this in a study of six Pakistani children. Among them was a magician who entertained the crowd by walking on hot coals.

In 2013, Nature published published another study, the subject of which was a little girl unfamiliar with the feeling of pain. German scientists at the University of Jena discovered that she had a mutation in the SCN11A gene, which encodes the Nav1.9 protein, another sodium channel responsible for pain. Overexpression of this gene prevents the accumulation of ion charges, and the electrical impulse does not pass through the neurons - we do not feel pain.

It turns out that our heroes received their “superpower” due to a malfunction of sodium channels, which are involved in transmitting the pain signal.

What makes us feel less pain?

When we are in pain, the body produces special “internal drugs” - endorphins, which bind to opioid receptors in the brain, dulling the pain. Morphine, isolated in 1806 and gaining fame as an effective pain reliever, acts like endorphins - it attaches to opioid receptors and suppresses the release of neurotransmitters and the activity of neurons. When administered subcutaneously, the effects of morphine begin within 15-20 minutes and can last up to six hours. Just don’t get carried away with such “treatment”; it can end badly, as in Bulgakov’s story “Morphine”. After several weeks of using morphine, the body stops producing endorphins in sufficient quantities, and addiction appears. And when the effect of the drug ends, many tactile signals that enter the brain, no longer protected by the anti-pain system, cause suffering - withdrawal occurs.

Alcohol also affects the endorphin system and increases the threshold of pain sensitivity. Alcohol in small doses, like endorphins, causes euphoria and allows us to be less susceptible to a punch in the face after a wedding feast. The fact is that alcohol stimulates the synthesis of endorphins and suppresses the reuptake system of these neurotransmitters.

Illustration copyright Getty Images Image caption We all know that pain is an objective reality, but its perception is deeply subjective. Pain can be a symptom, a disease, both mental and physical. How close are we to understanding what it is?

Acute, dull, sudden, chronic, aching, pulsating, blinding... This is not a complete list of epithets that we, without hesitation, use when talking about the sensation that we all have experienced and continue to experience: pain.

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She does not pay attention to skin color, eye shape, or social status. She doesn’t care at what level of evolution this or that creature is. Pain is experienced by people, dogs, cats, dolphins, whales, birds, frogs and even, according to scientists, earthworms.

At the same time, if scientists say that the mechanism of pain is more or less clear to them, then what is it: a signaling system of problems, an essential part of being, without which it is impossible to understand physical and mental well-being, a purely physiological process or the result of complex chemical processes in the brain, neither doctors nor even clergy came to a common agreement.

Illustration copyright Getty Images Image caption We know how the signaling system works through neurons to the brain and back, but many questions still remain unanswered

In addition, there is a group of people who, due to a genetic abnormality, do not experience pain at all.

In fact, there is no need to envy them, because they can easily miss the onset of some disease and die, although painlessly, but completely in vain.

All our knowledge about pain is built on paradoxes.

1. Our brain records signals of pain, but does not feel it itself.

Illustration copyright Getty Images Image caption The brain records and processes pain signals from all other parts of the body, but does not feel pain itself

Let's say you sprain your ankle or burn your finger. The nerve fibers immediately send a signal to your brain, which interprets the sensation as pain.

It is not for nothing that modern surgery became possible only after the discovery of anesthesia.

However, if the brain itself turns out to be the object of the operation, then it does not need painkillers.

The nerve cells in the brain send themselves the same signals as with a broken limb, but there is no data processing center for them.

The brain, accustomed to being responsible for the entire body, does not understand at all when it itself should be in pain.

There's something eerie about it, but patients are often fully conscious during brain surgery, allowing surgeons to see if they've delved too deeply into our body's main processor.

2. We all feel pain differently.

Illustration copyright DanielVilleneuve Image caption Pain is subjective: for some it is agony, for others it is a slight inconvenience.

The fact that, after, say, a natural birth, one woman says that it was a little uncomfortable, but nothing terrible, and another requires pain relief at the very beginning of contractions, does not mean at all that one of them is stoic, and the other is a weak weakling.

The way we feel pain is influenced by many factors: what chemical reactions are taking place in your brain at this time, whether there is an inflammatory process somewhere in your body, and how much you “remember” the painful sensations that you experienced before.

As the head of the New York Spinal Surgery Center, Kenneth Hansraj, once said: “Someone can drill into the shin bone without anesthesia, and he will calmly tell you, they say, buddy, pull this thing out! And another cannot stand even touching the thin skin needles."

3. You can distract yourself from pain

Illustration copyright Portra Image caption Pain can be deceived: if you start shaking your bruised finger, it becomes easier

Our brain is, of course, the most complex computer nature has ever created, but it is also a little dumb.

The fact is that it is difficult for him to simultaneously analyze several sensations.

Let's say you've been bitten by a mosquito and the bite area is desperately itching. Apply an ice cube to it, and suddenly you will realize that you still feel the cold, but the itching has disappeared.

That's why we instinctively rub a bruised area or frantically shake a finger that we accidentally caught in a door.

4. Redheads have it worse

Illustration copyright Getty Images Image caption Redheads have a hard time: fiery hair color is accompanied by an unconventional attitude towards painkillers

It's hard to believe, but in 2009, an article appeared in the Journal of the American Dental Association, according to which redheads really don't like visiting dentists.

The fact is that the same genetic combination that gives them fiery hair color also makes them less susceptible to certain painkillers.

And sometimes they need a dose that is twice as much as what would be enough for some brunette.

It is also possible that their body reacts to anesthesia in a less than trivial way. Some doctors, by the way, make adjustments to the patient’s hair color.

5. Sex saves you from pain

Illustration copyright Getty Images Image caption Having sex can reduce migraine pain... if you have the strength to do it, of course.

Well, objectively speaking, if you have a migraine attack, then sex in such a situation seems somewhat dubious.

However, there are some statistics that show that 60% of migraine sufferers felt much better if they did the same thing during an attack.

Sexual arousal releases endorphins in the brain, which are a natural pain reliever.

By the way, with migraine patients everything is not so simple. It is suspected that the same gene variation that gives migraine sufferers also significantly increases their libido.

6. We are mercilessly divided into women and men

Illustration copyright Getty Images Image caption We all feel the same, only men think we have to endure

In fact, there is no scientific evidence that men and women experience pain differently.

Although doctors note that in general, women are more often willing to admit that they are in pain.

Perhaps this is due to a social stereotype that requires “real” men to endure with clenched teeth.

7. Those who don't feel pain

Illustration copyright Getty Images Image caption For those who don't feel pain, it's not so good: simply touching a hot stove can result in a third-degree burn.

This is a very rare genetic abnormality. So rare that in the entire history of medicine it has only been encountered a few dozen times.

Those who were unlucky enough to be born with it can, for example, feel whether an object is hot or cold, but do not feel pain.

And this, by the way, is completely bad. For example, accidentally touching a hot stove may result in a third-degree burn, instead of the small blister that would have occurred if they had quickly realized what was happening and pulled their hand away.

According to the available statistics (which, for obvious reasons, are extremely small), the average life expectancy of such insensitive ones is significantly lower than the average.

8. The most common pain

Illustration copyright Getty Images Image caption The most common pain in developed countries is low back pain

This is back pain. Approximately 27% of people in developed countries claim to suffer from lower back pain.

Whereas from constant headaches or migraines - only 15%. Experts advise not to disdain physical exercise and not to gain excess weight.

However, this is a consequence of our evolutionary successes. Being bipedal is not at all conducive to spinal health. Four-legged animals, whose weight is distributed much more evenly, do not face back pain.

9. What ailed kings and dinosaurs

Illustration copyright Getty Images Image caption Both kings and dinosaurs suffered from gout. True, there is a dragon here, but it is probably a close relative of the tyrannosaurus

Gout, also known as arthritis, was previously called the disease of kings, because it was supposedly a consequence of excessive consumption of fatty foods and alcohol.

It is clear that in the distant Middle Ages only very wealthy people could afford this. We now know that the pain of gout comes from the formation of sharp uric acid crystals inside the joints.

A study of the upper limb skeleton of a female Tyrannosaurus rex (dubbed Sue by paleontologists) revealed that this particular Jurassic predator also suffered from gout, and in a very advanced form. It is likely that Sue suffered from chronic pain throughout the last years of her life.

10. The nature of pain is not at all clear

Illustration copyright Getty Images Image caption Sometimes pain turns from a symptom into a disease. It hurts everywhere, but it’s unclear why

Pain is a symptom, which, however, only gives a general idea that something is wrong, but does not give any specifics.

And in patients suffering from central pain syndrome, pain itself becomes a disease, and not its symptom.

Such patients complain of pain throughout the body, with sensations ranging from “pins and needles” to “severe pressure.” In this case, the brain is not just a recorder and processor of pain sensations, but also their main generator.

11. Don't underestimate your brain

Illustration copyright Getty Images Image caption Don't underestimate your brain: it knows perfectly well which buttons to press and in what circumstances.

The brain is designed to constantly evaluate the signals it receives, deciding how serious the danger is and whether immediate action should be taken.

Having received an alarm signal, the brain immediately tries to answer the main question: “How dangerous is all this really?”

In assessing the situation, our central processor uses all the information available to it: from subjective, coming from our past experience, to objective, obtained from the entire complex of physical and chemical parameters of the body.

And having received a signal, it sends “instructions” to the nerve endings on how to behave. Canadian physician Paul Ingram described the process in the following imaginary dialogue:

Illustration copyright Getty Images Image caption The brain commands neurons as it wants, and they have to obey

Nerve: Problem! Problem! Huge! Big! Red Alert! Turn it on immediately!

Brain: Mmmmm, huh? Okay, I took note. But here’s the thing, guys, I have a database here, sorry, it’s strictly secret, so take my word for it: it’s not all that scary. Relax.

Nerve: No, no, listen, this is all very serious!

Brain: Nope, I don't believe it.

Nerve: Listen, we may, of course, not have access to this “information” that you constantly talk about, but we know very well what such tissue damage is! And we're not playing with toys here. We won't shut up until you take action!

Nerve: Oh yes... What are we talking about? Damn, it looks like they just wanted to report something important... Well, okay, we'll come back later.

12. The most important boss

Illustration copyright Getty Images Image caption The brain itself decides how to regulate the pain button in our body, and why sometimes it stops at six and sometimes at ten, we still don’t fully know

The brain can indeed move its peripheral nerve endings as it pleases.

If he doesn't like something, he may ask for more information. Or maybe order his subordinates not to fuss.

In recent years, much information has emerged suggesting that nerves in the periphery may actually change, both physically and chemically, perhaps following commands from the brain.

As the same Paul Ingram noted: “The brain can not only turn the button that regulates the sound, but can easily change all the equipment, changing the signal itself long before it enters the speakers.”

Conclusion

The ultimate nature of pain, despite the fact that it is an integral part of the existence of all living beings, is still unknown to us.

We are faced with pain in life from the moment of birth, because it is not for nothing that we are born crying. And then we fail to avoid it: we fall, scratch ourselves, cut ourselves, get burned. And although we are always pretty angry with it in childhood, having matured, we begin to understand its importance. After all, if there were no pain, we could have died from our own rash actions or just accidents: we would have been seriously injured with simple kitchen knives, and having fallen asleep on the beach, or leaning against a hot radiator, we woke up with terrible burns. Indeed, pain is given to us for salvation, and as long as we feel it, we are alive and relatively healthy.

There are diseases in which there is insensitivity to pain:

  1. Paralysis as a result of a stroke: the localization of insensibility is tied to the part of the brain where the hemorrhage occurred.
  2. Diseases that cause conduction disorders of the spinal cord: injuries, late stages of vertebral dorsopathy, for example, intervertebral hernia, infectious diseases of the spine.
  3. Leprosy and other diseases

Have you ever asked yourself: why do we feel pain?

This question has always been of great concern to neurologists, neurosurgeons and other doctors. After all, knowing why pain occurs, you can come up with a mechanism to protect against it. This is how the famous analgesics arose, and then stronger substances that combat pain symptoms.

We feel pain thanks to special receptors - nerve endings, which are supplied to all the nerves of our peripheral nervous system. A web of nerves covers the entire surface of our body. This is how nature protected us from harmful external influences, arming us with reflexes: if it hurts, we pull our hand away. This occurs due to the sending of a signal to the brain by the irritated receptor and the subsequent response of a lightning-fast order-reflex from it.

The deeper, the less sensitive the nerves. They are programmed for a different task: protecting the spine and internal organs. The spine is protected by the nerve roots emerging from the spinal cord, and the internal organs are protected by the autonomic nervous system, which is designed intelligently, with different sensitivity for different organs.

Three thresholds of pain protection

If our nerve endings and roots responded to literally all pain signals, we simply would not be able to live due to constant suffering. Therefore, the Creator, for our salvation and the salvation of the brain, so that it would not be distracted by trifling scratches, came up with as many as three pain thresholds for protection. The threshold is overcome when the number of pain impulses exceeds the conventional permissible value.

  1. The first threshold is at the level of the PNS (peripheral nervous system). This is where minor irritations are filtered out. That's why we don't cry over a small scratch, and we may not even notice it.
  2. The second threshold is located at the level of the CNS (central nervous system), in the spinal cord. What happens here is the filtering of pain signals that have passed through the threshold of the PNS, the analysis of radicular signals arising from vertebral pathologies in the back, the analysis of pain impulses that are sent by the autonomic nervous system, which connects all internal organs with the central nervous system.
  3. The third threshold (the most important) is the pain threshold located in the brain of the central nervous system. The brain has to decide, through complex analysis and counting of impulses from all pain receptors, whether this total represents a danger to us, and whether to signal us about it. All these operations are performed by brain neurons in a fraction of milliseconds, which is why our reaction to painful stimulation is almost instantaneous. Unlike previous thresholds, which transmit impulses thoughtlessly upward, the brain approaches this analysis selectively. It can block pain signals or reduce pain sensations using endorphins (a natural pain reliever). During stress and critical situations, adrenaline is produced, which also reduces pain sensitivity.

Types of pain and its analysis by the brain

What types of pain are there, and how are they analyzed by our brain? How does the brain manage to select the most important ones from the huge number of signals supplied to it?


According to our perception, pain is of the following types:

Acute

It looks like a knife blow, its other name is dagger

Acute pain occurs suddenly and lasts intensely, warning our body of serious danger.

  • Injuries (cuts, puncture wounds, fractures, burns, spinal bruises, ruptures and avulsions of organs due to a fall, etc.)
  • Inflammation and purulent abscesses of internal organs (appendicitis, peritonitis, perforation of an ulcer, rupture of a cyst, etc.)
  • Vertebral displacement, intervertebral hernia and other spinal diseases

If in the first two cases the pain is constant, then in the third it has the character of a lumbago (lumbago or ischias), which is typical, for example, for all acute back pain

Chronic

It is permanent and can be aching, pulling, or spread over the surface. The areas where the disease is localized are characterized by increased sensitivity.

Chronic long-term pain is an indicator that some organ inside us has not been healthy for a long time

It periodically becomes acute during the next attack of the disease.
Examples:

  • Cholecystitis, pancreatitis, gastritis
  • Rheumatoid arthritis, bone tuberculosis
  • Osteochondrosis, spondylosis, intervertebral hernia

The close connection between acute and chronic pain manifestations is clearly demonstrated by back pain. A lumbago in the back (lumbago) after a few days turns into a constant aching pain - lumbodynia, which indicates that the disease has not gone away - it is always with us.

Chronic and acute pain travel through different nerve fibers. A fibers with a protective myelin sheath are intended for acute pain and are a priority. B fibers are used for chronic and are secondary. When a focus of acute pain occurs, fibers B are switched off, and impulses from fibers A, as the most important, enter the brain. The speed of signal transmission through them is 10 times faster than in B fibers. That is why when acute back pain occurs, the chronic one disappears somewhere, and we always feel the acute one more intensely than the chronic one.

In fact, chronic pain, of course, has not gone away, it just temporarily ceases to be recorded. This rule is also true for several sources of pain. For example, in addition to intervertebral hernia, you also have osteoarthritis. Acute back pain due to an attack of a hernia will temporarily turn off the aching chronic ones, and vice versa: an exacerbation of osteoarthritis will overshadow the chronic process caused by a hernia.

Chronic pathological

It exists constantly, it causes torment, it is “unhelpful”, and the reason for it is sometimes difficult to explain. This is a kind of failure in the system of transmitting pain impulses at some level. Examples

  • Phantom pain - occurs when a limb is amputated (the limb is gone, but the pain remains)
  • Syringomyelia (painful sensitivity, another name is “anesthesia dolorosa”)
    A paradoxical disease in which severe pain is simultaneously felt, but at the same time what hurts (for example, an arm, leg or other area) is absolutely insensitive to external stimuli. A sign of such patients is a lot of burns on their arms or legs. The disease is caused by morphological changes in tissue in the spinal cord.

And in conclusion:

Do not try to treat pain without finding out its cause - it can be deadly!

In what cases, for example?

  • Attack of appendicitis
  • Exacerbation of cholelithiasis
  • Spinal bruise
  • Heart attack
  • Perforated ulcer and many other diseases

Be healthy! Be more attentive to your feelings.

Video: How do we feel pain?

Continuation

Watch the video: Tension in the body | lower back pain | exercises treatment of osteochondrosis


What is pain? Pain is a signaling function of the body, notifying a person about some problems in his body.

PAIN, a psychophysiological reaction of the body that occurs with strong irritation of sensitive nerve endings embedded in organs and tissues. One of the earliest symptoms of some diseases.

It seemed that it would be good if we did not feel pain (unfortunately, such people exist), but how then would we know about the “accident” of our body? For example, when the appendix becomes inflamed, we feel pain in the abdomen and consult a doctor. The doctor examines us and treats us. If a person did not feel pain, he would simply die from peritonitis when the inflamed appendix ruptured inside him. Therefore, pain is a great benefit that protects a person from many troubles.

All people tolerate pain differently, some can endure very severe pain, while others are unable to cope with even a small cut on their finger. For a correct diagnosis, the severity of the pain is not so important as its characteristics: HOW it hurts; WHEN it hurts; WHERE does it hurt; other symptoms associated with pain.

A disclaimer was made above that not all people are able to feel pain. Why? It's quite simple. The mechanism of pain is approximately as follows:

  • nerve endings perceive an irritating factor caused by an “emergency” situation in the body;
  • a nerve impulse (a kind of “alarm signal”) is transmitted along nerve fibers through the spinal cord to the brain;
  • the brain processes the information received, interprets the distress signal, and communicates pain to us.

Violation of any link in this chain of transmission and processing of nerve impulses leads to an inadequate response to a painful stimulus. For example, during hypnosis, when the hypnotist turns off certain areas of a person's brain, he may not respond to acute pain. Another clear example is patients who have suffered spinal cord injuries (for example, a spinal fracture) - the vast majority of such patients are absolutely insensitive to any irritation of the legs and pelvis.

NERVE- strands of nervous tissue formed mainly by nerve fibers. Nerves connect the brain and ganglia with other organs and tissues of the body. The collection of nerves forms peripheral nervous system.

The best way to relieve pain is to eliminate its cause. You should try to avoid long-term use of strong painkillers (unless, of course, it is related to the relief of dying pain) as much as possible. Otherwise, a person risks becoming dependent on such drugs, which will inevitably lead to the development of complications.

ATTENTION! Information provided on the site website is for reference only. The site administration is not responsible for possible negative consequences if you take any medications or procedures without a doctor’s prescription!

How people feel pain and why the body needs it. How the mechanism of pain perception works, why some people do not feel it at all, and also how the body protects itself from pain, says the science department of Gazeta.Ru.

We feel pain every day. It controls our behavior, shapes our habits and helps us survive. Thanks to pain, we put on a cast on time, take sick leave, pull our hand away from a hot iron, are afraid of dentists, run away from a wasp, sympathize with the characters in the movie “Saw” and avoid a gang of hooligans.

Fish are the first organisms on Earth to feel pain. Living beings evolved, became more and more complex, and so did their way of life. And to warn them of danger, a simple survival mechanism appeared - pain.

Why do we feel pain?

Our body consists of a huge number of cells. In order for them to interact, there are special proteins in the cell membrane - ion channels. With their help, a cell exchanges ions with another cell and comes into contact with the external environment. Solutions inside cells are rich in potassium but poor in sodium. Certain concentrations of these ions are maintained by the sodium-potassium pump, which pumps excess sodium ions out of the cell and replaces them with potassium.

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The potassium-sodium pumps are so important that half of the food eaten and about a third of the oxygen inhaled goes towards providing them with energy.

Ion channels are the real gateways of the senses, thanks to which we can feel heat and cold, the scent of roses and the taste of our favorite dish, and also experience pain.

When something acts on the cell membrane, the structure of the sodium channel is deformed and it opens. Due to changes in the ionic composition, electrical impulses arise that spread throughout the nerve cells. Neurons consist of a cell body, dendrites and an axon - the longest process along which the impulse moves. At the end of the axon there are vesicles with a neurotransmitter - a chemical substance involved in the transmission of this impulse from a nerve cell to a muscle or to another nerve cell. For example, acetylcholine transmits a signal from a nerve to a muscle, and between neurons in the brain there are many other mediators, such as glutamate and the “happy hormone” serotonin.

Cutting your finger while preparing a salad has happened to almost everyone. But you don’t continue cutting your finger, but pull your hand away. This happens because the nerve impulse runs along neurons from sensitive cells, pain detectors, to the spinal cord, where the motor nerve transmits the command to the muscles: remove your hand! Now you have covered your finger with a bandage, but you still feel pain: ion channels and neurotransmitters send signals to the brain. The pain signal passes through the thalamus, hypothalamus, reticular formation, parts of the midbrain and medulla oblongata.

Finally, the pain reaches its destination - the sensitive areas of the cerebral cortex, where we are fully aware of it.

Life without pain

Life without pain is the dream of many people: no suffering, no fear. This is quite real, and among us there are people who do not feel pain. For example, Steven Peet was born in the USA in 1981, and when he started teething, he began to chew his tongue. Fortunately, his parents noticed this in time and took the boy to the hospital. There they were told that Stephen had a congenital insensitivity to pain. Soon after, Steve's brother Christopher was born, and the same thing was discovered in him.

Mom always told the boys: infection is a silent killer. Without knowing pain, they could not see the symptoms of diseases in themselves. Frequent medical examinations were necessary. Having no idea what pain was, the guys could fight to the death or, having received an open fracture, hobble around with a protruding bone without even noticing it.

Once, while working with a power saw, Steve cut his arm from hand to elbow, but he sewed it up himself, being too lazy to go to the doctor.

“We often missed school because we ended up in a hospital bed with another injury. We spent more than one Christmas morning and birthday there,” says Stephen. A life without pain is not a life without suffering. Steve has severe arthritis and a bad knee - this threatens him with amputation. His younger brother Chris committed suicide after learning he might end up in a wheelchair.

It turns out that the brothers have a defect in the SCN9A gene, which encodes the Nav1.7 protein, a sodium channel involved in the perception of pain. Such people distinguish cold from hot and feel touch, but the pain signal does not pass through. This sensational news was published in the journal Nature in 2006. Scientists discovered this in a study of six Pakistani children. Among them was a magician who entertained the crowd by walking on hot coals.

In 2013, another study was published in Nature, the subject of which was a little girl unfamiliar with the feeling of pain. German scientists at the University of Jena discovered that she had a mutation in the SCN11A gene, which encodes the Nav1.9 protein, another sodium channel responsible for pain. Overexpression of this gene prevents the accumulation of ion charges, and the electrical impulse does not pass through the neurons - we do not feel pain.

It turns out that our heroes received their “superpower” due to a malfunction of sodium channels, which are involved in transmitting the pain signal.

What makes us feel less pain?

When we are in pain, the body produces special “internal drugs” - endorphins, which bind to opioid receptors in the brain, dulling the pain. Morphine, isolated in 1806 and gaining fame as an effective pain reliever, acts like endorphins - it attaches to opioid receptors and suppresses the release of neurotransmitters and the activity of neurons. When administered subcutaneously, the effects of morphine begin within 15-20 minutes and can last up to six hours. Just don’t get carried away with such “treatment”; it can end badly, as in Bulgakov’s story “Morphine”. After several weeks of using morphine, the body stops producing endorphins in sufficient quantities, and addiction appears. And when the effect of the drug ends, many tactile signals that enter the brain, no longer protected by the anti-pain system, cause suffering - withdrawal occurs.

Alcohol also affects the endorphin system and increases the threshold of pain sensitivity. Alcohol in small doses, like endorphins, causes euphoria and allows us to be less susceptible to a punch in the face after a wedding feast. The fact is that alcohol stimulates the synthesis of endorphins and suppresses the reuptake system of these neurotransmitters.

However, after alcohol is removed from the body, pain thresholds are reduced due to inhibition of endorphin synthesis and increased activity of their uptake, which does not alleviate the hangover typical of the next morning.

Who hurts more: men or women?

Women and men experience pain differently, according to a study by McGill University scientists who found that the perception of pain in female and male mice begins in different cells. To date, many studies have been conducted on the nature of women's and men's pain, and most of them indicate that women suffer from it more than men.

In a large-scale 2012 study in which researchers analyzed the records of more than 11,000 hospital patients in California, scientists found that women experience pain worse and experience it more often than men. And plastic surgeons from the USA have found that women have twice as many nerve receptors per square centimeter on their facial skin than men. Girls are already so sensitive from birth - according to a study published in the journal Pain, newborn girls' facial reactions to injections in the foot were more pronounced than boys. It is also known that women are more likely to complain of pain after surgery and feel worse in the dentist's chair.

Hormones come to the aid of poor women.

For example, one of the female sex hormones, estradiol, reduces the activity of pain receptors and helps women tolerate high levels of pain more easily.

For example, estradiol levels rise sharply before labor and act as a kind of pain reliever. Unfortunately, after menopause, the level of this hormone in the body becomes lower, and women endure pain more severely. By the way, men have a similar situation with testosterone. The level of this male sex hormone decreases with age, and some pain symptoms become more pronounced.

But pain is not only the transmission of nerve impulses to the brain, it is also the psychological perception of pain. For example, participants in one interesting study had a threefold increase in pain threshold after they were shown how another participant calmly endured the same pain. Boys are taught from birth to be courageous: “boys don’t cry,” “you must endure,” “it’s a shame to cry.” And this makes a significant contribution: men endure pain steadfastly, and the brain “thinks” that they are not in so much pain.