Outbreaks of pain

In the presence of a manifest harmful event (consummated or imminent necrosis), the pain arises from the brain as a result of the arrival of a damage signal flow that was generated in the afflicted area. Nociceptors (vigilant neurons of damage) transform (transduce) the molecular messages of the attacked cells and the responsible stimulus (mechanical, thermal, chemical, biological) into electrical potentials that activate the group of brain areas that generate the perception of pain.

– My right index finger hurts. I’ve accidentally hit it with a hammer. See how it looks. It’s swollen … I can’t even touch it…

In this case, the perception of pain has a clear origin, an event that generates a noxious stimuli enough for the brain to project the painful perception on that area.

The problem comes when we feel pain in the absence of a noxious event or state capable of stimulating nociceptors. Pain receptors of damage need a stimulation of sufficient intensity. A heat nociceptor only generates a signal above 45ºC. There are also other heat receptors that are activated under 45ºC and we feel painless heat but, if we pass that limit, we feel pain. The nociceptors of dangerous heat have been activated and the nociceptors of harmless heat have been turned off.

An area hurts. There are no extreme temperatures. No dangerous mechanical, chemical or biological stimulus turns on any nociceptor. Nothing relevant is happening there… but the perception of pain has sprung from the brain. Project, there and now.

What makes this perception of the painful brain areas emerge?

The answer is simple. A threat assessment has been produced in the predictive memory systems. The brain expects possible damage. There and now. Why? We don’t know. The brain represents reality as a probability without expecting it to actually happen.

The pain can be reached both by noxious events and their “pre-diction”. No confirmation of the feared is needed. The pain is not only a result of the consummated or imminent harm. It’s also the result of the theoretical evaluative states of the “pre-feelings”.

The outbreak of pain forces the individual to pay attention and evaluate the painful area, consider what may be happening and what it may be due to (trigger).

The outbreak may happen after eating chocolate or changing weather conditions.

– My head hurts. I shouldn’t have eaten chocolate.

Really the chocolate hasn’t activated a population of nociceptors. The painful brain areas have been turned on by the action: eating chocolate, a forbidden food for being classified as potentially harmful.

The evaluative brain judges states, events, actions, omissions … to which it attributes a capacity of threat. The pain arises when it reaches the theoretical, speculative danger level in the representation of the body. Nothing happens or is going to happen, but the theoretical attribution is enough to bring out the painful perception. Aggression, consummated or imminent nocivity is not necessary. There is no flow of nociceptive signal.

Since the moment the individual receives the perceptive projection of pain, he is involved in its development. He will have to make decisions, consider possible causes and remedies.

– It hurts. Why? What I can do to make it stop?

Culture has instructed us in the external solution:

– Take a painkiller. Don’t wait.

Even if nothing happens, the brain, the organ of the virtual, of the imagined, requires what it believes should be done. If in its circuits it’s said that he should take the painkiller, the pain will remain until the individual meets the requirements.

– I didn’t want to take anything but, in the end, I had to …

Pain requires behaviors, actions. That’s the function of any perception, proposing actions, selecting aspects of reality, filtering, amplifying …

Outbreaks depend on the neuronal network’s dynamics. They don’t adjust to the logic of tangible causes and effects.
In pain outbreaks caused by evaluative and probabilistic dynamics, irrationality, error, phobic and superstitious fear and addiction to relieving behaviors are the ones that rule.

Any irrational action can neutralize the irrational fear. The brain’s instruction to demand it is enough. The nocebo and placebo relay on irrelevant conditions. They turn the harmless into potentially destructive, and the unnecessary into a necessary and sufficient remedy.

The probabilistic cerebral ravings are corrected by pruning the weights of the neuronal connectivity that attribute danger to the non-dangerous. We must project rationality, knowledge, bringing virtuality to reality

– Don’t buy lottery tickets. You won’t win.

– And what if that number is the winner? The need to buy it has sprung.

Virtual battles must be fought in the virtual field, but we don’t always win. It’s a matter of time, perseverance and determination.

– The pain has sprung. The brain hallucinates. It imagines pain … What a cross to bear!!

This entry was posted in imagined damage by arturo goicoechea. Bookmark the permalink.

About arturo goicoechea

Born in Mondragón, Guipúzcoa, in 1946. Head of the Neurology Department at the Santiago Hospital in Vitoria (Álava), Spain. Published books: Jaqueca, 2004. Depresión y dolor, 2006. Cerebro y dolor (Esquemas en dolor neuropático) 2008. Migraña, una pesadilla cerebral, 2009.

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