Biological reasons for sensing pain
We are starting to understand that there really may be some truth to what some patients say when they claim that “they felt everything” despite being under anesthesia.
Some of us metabolize local anesthesia medications such as Lidocaine and Novocaine faster than others, and some may even have fewer receptors for the medication to work on. This would explain why some patients do not get the same relief as others. The medications really “do not work” on some.
In the same way, the effects of narcotics and other medications on the brain and other tissues may be limited by physical differences in our tissues where the opioids do not or cannot bind to receptors to show their effects.
Even more interesting is an effect I have seen on multiple occasions. The same patient comes back for a repeat procedure in the same area of the body but on a different day, but their reaction to the pain is totally different. It’s as if our daily differences in hormone levels alter our perception. If you are having a bad day you will feel bad things more.
Expectations of pain relief—the perception of pain
Without getting too complicated, it turns out that if you expect a medication to work, it will—and if you think it will not work… it won’t. Expectations of efficacy in our brains play an important role in our perception of discomfort. You can literally psych yourself into not feeling pain. We have all heard of the soldier who is shot and yet keeps on going to save ten others.
Our brains can very effectively block out negative experiences and sensations. The injured area still produces the signals to alert us of injury and pain, but the brain does not pay attention to them.
No one knows yet how these effects work, but the latest research shows that expectations of pain are controlled by different physical areas of the brain.
Here is a link to a news article that came out on this subject just a few days ago: http://www.bbc.co.uk/news/health-12480310
Since I wrote this article a few years ago there has been an explosion of narcotic drug abuse in the USA and new methods of drug dispensation control are now in place. Computers monitor how many prescriptions are given to each patient and there are strict limits on how much pain medication can be dispensed. The new reality is that narcotics are being reduced, other meds added for pain control and ultimately patients must learn to deal with the pain in their heads- even though it’s coming from their bodies!
So what do you think about pain?