Neurobiology of Pain Processing

For as long as I can remember, when I’ve seen someone with an injury, especially a big injury, for example when Sean was 3 and took a header in the tub and I couldn’t grab him in time and he split his chin open, I have a physical reaction to it.  When Sean got the stitches in his chin, I was the one sitting on a chair in the corner with my head between my knees.  This is an extreme example, because I think every mother feels her child’s pain to some degree, and when the injury happens on the mother’s watch, it’s all the more painful.  However, when I see someone with a pronounced limp or their arm in a sling or wincing, etc, I can at times, not always, feel pain in my leg, arm, hand, whatever.  It’s reason number 72 why I could never be a doctor or nurse.  That and the whole sit down with my head between my knees thing.

I always figured it was a sign of hypersensitivity or neurosis, and it could well be. However, I found a study by Rahm et al (see library – it’s caught up) that actually looks at this phenomenon in people with fibromyalgia (I’m not alone!).  They take it to a different level, however, and look at pain processing in first and second person.  Patients and a control group were given pictures of people in painful situations, such as a door swinging on a toe, and then told to think of themselves in that painful situation (first person) and then to think of someone else (who they don’t know – second person) in that situation.  And their brains were scanned and the blood oxygen levels in the brain were measured while they did this exercise.  This goes back to the regions of the brain that are affected by fibromyalgia (or chronic pain, I think), and the researchers were looking for confirmation that the brain was linked to the disturbed pain processing that people with fibromyalgia experience.

Their results, which I hope I’m representing okay, indicate that the responses of patients to visual stimuli – along the pain processing network in the brain – were stronger in terms of the blood oxygen levels.  In other words there was more of a stimulation.  This, according to the authors, provides evidence for “sensitization of central nervous pain processing” in patients with fibromyalgia.  In other words, when I see someone stub their toe while taking a corner too quickly and I start to limp, I’m not crazy.  My brain just jumps to attention and salutes.


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