Podcast 607: Is Pain the Enemy?

<p><strong>Contributor: Don Stader, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Pain is ubiquitous in the emergency department but it is not the enemy - suffering is</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Nociception is the ability to feel noxious stimuli which usually causes a reaction, like pulling a limb away when you feel something painful. Nociception is really a brainstem reflex.</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Pain is nociception plus cognition, meaning we process the noxious stimuli in our frontal cortex but it is not necessarily suffering. </span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Pain can be associated with euphoria, such as with distance running</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Suffering, unlike pain, is associated with emotional distress</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Nociception is a brainstem reflex, pain involves the brainstem and the frontal cortex, while suffering involves the brainstem, frontal cortex, and the limbic system attaching an emotional response</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Providers should educate patients’ expectations on pain as a part of the physiologic process and emphasize the focus on alleviating suffering</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Sneddon LU.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/29212893/"><span style= "font-weight: 400;">Comparative Physiology of Nociception and Pain</span></a><span style="font-weight: 400;">. Physiology (Bethesda). 2018 Jan 1;33(1):63-73. doi: 10.1152/physiol.00022.2017. PMID: 2921289</span></span></p> <p><span style="font-size: 10pt;"><em><span style= "font-weight: 400;">Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD