Why Things Hurt

Lorimer grew a mo.  To help promote men’s health.  It was during this time that he, and his mo, gave a talk at TEDx.  Here it is.

Comments

  1. Barbara F. Manning says:

    I am glad to find out about how the brain creates and perpetuates pain. but what I REALLY want to know is about treatments/therapies/programs that CURE it!

    Have you done any talks about this?

    Is there anywhere to go to find out this kind of information?

    Thanks! I loved watching this!

    Barbara

  2. Re: the lack of awareness, I and many other people in pain will reprt that they have no awareness of pain when they are deeply involved in something however, at some point the pain becomes so overwheloming it takes us outof the distration and, by that time, the pain of which we were unaware has risen to a level beyo0nd which is tolerable. If, for example, I am on the computer doing something exceedingly engaging, I will not attend to the fact that the eye pain is increasing but, by the time, I become aware of the pain I have so overused the eye while engaged that the pain will not relent for a much longer time then if I had stopped early on. IThis reminds me of when a nurse taught me that ou cannot feel 2 sensations at the same time so if I get a slap in the area where I am to get an injection I will feel the sting of the slap and not the discomfort of the needle. I am not sure this is an outright one to one analogy but it feels close.
    As for sleeping, trigemina neuralgia used to have as one of the signs, signs that the pain, triggered, spontaneous, never occurred during sleep. (They have since changed the signs and symptoms.)
    When first being diagnosed I was asked “Does t awaken you from sleep?” I always replied. “I do not know if I had it during sleep and it awakened me or the few times it happened if I was wakened by something else and then had the pain while awake.”
    I have seen people moan in apparent pain while asleep. It would be initeresting to see if on an asleep eeg there were indices of pain.
    Carol

  3. GDay Mike – “Almost everyone I have met in pain reports times, however briefly, when they where totally engaged in something where they where without the awareness of pain” – absolutely – no awareness of pain means no pain. If one can really get a handle on the idea that pain is produced, not registered, then this observation becomes more sensible I reckon – the brain is busy doing something else.
    “so is there a pain response occurring during sleep that is overridden by sleep or is there no pain response during sleep?” This is a great one and I have just written something in a post to come shortly, about sleep. I reckon, unless you are actually in pain in your sleep and I haven’t met anyone who has convinced me that they are, then there is no pain during sleep. This comment will attract some attention from people who are sure their pain woke them up, but on really thinking about it, their pain only existed when they were awake enough to have it. AAAgh – it is a tricky beast indeed.

  4. Thanks very much for the reply and for the offer of assistance.
    I think the “convincing” part for most people in pain will be in the specialists structuring experiences that enable a person with a pain response (is that a better way of say it – rather then “in pain”?) to experience a state where the response is altered – accompanied by “I did that”.
    There are a couple of things that have puzzled me about pain. Almost everyone I have met in pain reports times, however briefly, when they where totally engaged in something where they where without the awareness of pain. And related, even the most sleep deprived person in pain will sleep sometimes, however briefly, so is there a pain response occurring during sleep that is overridden by sleep or is there no pain response during sleep?
    Thanks again for the reply and super work.

  5. It took me many years to realize the pain really is “in my head” . I have trigeminal neuralgia, (a 5th cranial nerve facial pain disorder.) As a result of a number of surgical mishaps I have dyesthesias and anaesthesia dolorosa. There is no question in my mind that this is the result of errant connections and possibly errant memory in the brain. The ‘danger’ notice from the brain goes off with the first pain, as appropriate, but never seems to go off. Having the neuro basis more understood will, in the end, I believe, give us the answer to many chronic pain disorders, not only those that are neurological in basis. I wait expectantly for the next talk when he can say “and we know what to do about it.
    Thank you.
    Carol Jay Levy
    author A PAINED LIFE, a chronic pain journey
    The Pained Life, 30 years, and counting.http://apainedlife.blogspot.com/
    accredited to the U.N. Convention on the Rights of Persons with Disabilities member U.N. NGO group, Persons With Disabilities

    Carol Levy Reply:

    Just an addendum. I have a completely experimental sensory cortical stimulator implant. It was helping the eye movement/eye usage pain that continues to disable me.
    It recently failed, setting off very strong unpleasant stimulation throughout my left face (where the TN is located) and on the right (where it is not supposed to give stimulation). Even after turning it off I continued to get this stimulation, which became lighter and has almost completely stopped.
    Neither the company that makes the stimulator nor the neurosurg have any idea what is wrong. The quesion is: is the implant broken but the break is not visible on xray or, is the sensory cortex ‘remembering’ the sensation?
    I have had this in and turned on for 20 years. Is that the longest the cortex can tolerate stimulation?
    My neurosurg has said I could ask ‘many, many people in the world’ and no one will have the answer, either as to what to do about the pain or what is going on with the implant. Because the question regards both the implant and the cortex, there is no way to know if my brain could tolerate another implant.
    Until we get better answers to the questio(s) of what the brain is doing to continue the chronic pain even experimental treatments may be nothing more then blowing in the wind.
    Carol

  6. Terrific talk but a terrible dilemma. I showed this to my wife who has had chronic pain for many years. She enjoyed the talk but politely suggested that Lorimer has no idea what its like to be in constant pain and was completely unconvinced that pain is in the embodied brain. Her experience doesn’t match the explanation. What worse I can see that her explanation is a self reinforcing web of pain signals, personal history, seeking security in what you know (pain) and limited ability to envisage a future. I have also noticed that while I am fascinated that our central nervous system really can’t be trusted that’s the last thing most people in pain want to hear – another bit of me is wrong! Lorimer hinted towards the end that there are ways forward and I’d really like to see him outline these. I’m also pretty sure that for most people in pain, help is going to need to be a combination of clinical assistance and theater, as a way to create a new sense of self, behaviours and possibility. Thanks for a great and important website.

    Lorimer Reply:

    Thanks Mike – There is no doubt in my mind that I don’t know what it is like to be anyone else in pain. Therein lies one of the complexities that makes understanding and treating chronic pain so difficult. Your wife is correct insofar as I have no idea what it is like to be her and if I implied that I did I am sorry and embarrassed about that – I do not like the ‘I know how you feel’ thing. Your point about ‘another part of me is wrong’ is a good one too – in clinical practice, we try very hard to package this reality in opportunity rather than despair and, as you observe, that talk was more about why things hurt, not how to treat it.

    Ultimately, I reckon the modern understanding of chronic pain is one of opportunity, but it seems, in that 18min talk, I did not convince everyone! There are indeed ways forward, but they require time, patience, persistence, courage and support. and, as you say, a dose of theatre. There is no doubt in my mind that to overcome chronic pain is not easy and is not quick. I would be very happy to see if we can put you guys in touch with someone in your area who might be able to help with the ways to move forward. No obligation of course – and thanks a million for your comment – it is important and deserved a much quicker response!