Thoughts on pain

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I have just been sent a link to the McGill University website in Montreal. This I found interesting. I never realised that my pain is part of a wider Cartesian discourse. I think therefore I...OW!

"Until recently, most people who considered the problem agreed with the concept first proposed by French philosopher René Descartes in 1664 that pain is an alarm that signals injury to the body, that pain stimuli travel to the brain and the brain registers them. Pain, according to this theory, is therefore necessary, unavoidable and inevitable.

That was before Dr. Ronald Melzack came along. He is a McGill psychologist widely regarded as one of the fathers of pain research because of the pivotal Gate Control Theory of pain that he developed with Dr. Patrick Wall, a British biologist.

First published in 1965, it suggests that a "gating system" in the spinal cord opens or closes to increase or decrease pain messages to the central nervous system and the brain. It also argues that the brain has a dynamic role in the way the body processes pain depending on experience, genetics and other psychological influences.

When the theory was published and absorbed, it caused a sensation. Researchers in disciplines ranging from zoology and physiotherapy to anaesthesiology and dentistry saw new possibilities and followed up. So did Dr. Melzack.

In 1971, he published what is still known as the McGill Pain Questionnaire.

It asks patients to evaluate their own pain using words like throbbing, shooting, stabbing, sharp, cramping, gnawing and burning and then decide whether it is mild, moderate or severe.

Melzack recognized that such descriptions were subjective but he argued that they could be quantified. Today, doctors and nurses around the world use the questionnaire as a useful tool for diagnosis.

Then, he turned his attention to phantom limb pain - the real pain that people feel in a limb after it has been amputated or after they have suffered a serious injury to the spinal cord.

This led him to argue that the brain has a built-in "neuromatrix" of nerve cells that creates patterns of physical sensation, even when the part of the body they map is no longer there. 

"Where do we go from here?" he asked in 1999 in an article in the journal Pain.

"I believe the great challenge ahead of us is to understand brain function.

"The brain generates the experience of the body," he wrote. "Sensory inputs merely modulate that experience; they do not directly cause it."

Melzack had turned Descartes' theory on its head."

There. See?

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