We have all experienced pain and we all wish we could avoid it. Yet, physical suffering saves our lives and makes society less closed and selfish.
Pain is the negative experience par excellence: we’ve all experienced it and we’d all like to stay away from it. So much so that, if we were offered the chance to get rid of it forever, we would certainly say yes. On closer inspection, however, it would not be the right choice. Pain is a sign that something is wrong. “If it weren’t there we would be continuously exposed to harmful stimuli and the body would be damaged even to death,” explains Fabrizio Benedetti, professor of neurophysiology at the University of Turin, one of the world‘s leading experts on pain and the placebo effect.
Why aren’t children afraid of pain? «We see it very well in children affected by a very rare condition, called congenital insensitivity to pain, in which some genetic mutations compromise the development of the nerve fibers which, passing through the spinal cord, carry sensations from the body to the brain. These are extreme and dramatic situations. These children cause themselves self-mutilation (for example, they bite their nails and reach their fingers without even realizing it, ed) and are often the victims of serious accidents or bone fractures, because, not being held back by the fear of getting hurt, they engage in extremely risky. They must be continuously monitored but often do not reach adulthood, due to accidents but also to other health problems connected to the genetic mutations they carry”.
Do animals suffer? In short, pain saves our lives. But, despite its importance for us humans, it is not known exactly when it appeared in the course of evolution, and it is not even said that it is present in all living beings. “If we asked a group of people if a monkey feels pain, 100% would say yes. The same would be true with a cat and probably all other mammals. But already with fish someone would begin to doubt, while with worms or insects, half of the people questioned would probably say that they are unable to feel pain», observes Benedetti. “The point is, science has no way of verifying that.” Of course, if an insect is attacked it activates defense reactions. “But it is not said that it is a response to pain,” continues the expert. In short, there could be other mechanisms which do not involve suffering and which are in any case capable of inducing protective behaviors in the event of danger. If we humans didn’t feel pain, maybe we would have preserved and maybe enhanced them.
What is asymbolia for pain? To better understand this concept we need to delve into the mechanisms that underlie our suffering. «The brain has two pain systems: the lateral one is able to recognize the pain stimulus and to understand from which point of the body it originates; the medial one – which also involves the limbic system (which is the basis of many emotions, ed) – instead generates suffering and gives pain its negative emotional connotation», continues Benedetti. “There is a rare condition, called pain asymbolia, in which the medial system is damaged or malfunctioning. These people are perfectly able to detect the presence of a pain stimulus and know how to locate it, but they do not feel any pain.
If there really were animals that didn’t feel pain, their perception and defense reaction could be generated by a similar mechanism, perhaps accompanied by the activation of other senses or other abilities. “A patient of mine suffering from pain asymbolia learned to regulate the temperature of the water in the tub, and to avoid it being too hot, based on the redness that the skin takes on when she immerses herself,” says the expert. If we didn’t feel pain, then, we may have refined our ability to observe the body for warning signs, relying more on sight, smell and other tactile sensitivities. However, they would be less direct and less efficient systems with respect to suffering, which goes straight to the brain and determines an immediate defense reaction.
The suffering of others. But pain asymbolia also has another interesting feature: in fact, it determines the almost total absence of stress and anxiety in those affected. A couple of years ago, The New Yorker ran the story of Jo Cameron, a woman with the condition, who she remembers feeling anxious only once in her life: when she saw her son seriously injured. serious after being involved in a fight. “These cases also tell us a lot about the close links that exist between physical and psychological suffering,” comments Benedetti. “If we didn’t feel physical pain we would be less anxious and stressed, and yet other emotional reactions would also be muffled.” Precisely for this reason, we would be even less willing to help others. “When you see a person in pain, the same areas of the limbic system that generate our physical pain are activated,” explains Benedetti.
It’s the mechanism that underlies empathy and triggers the desire to help. Without it, society would be more individualistic and less supportive.
The pain that is useless. However, there is also a pain that is useless and which we could easily get rid of and live more serenely. It is chronic pain, which can be associated with diseases such as arthrosis, but which is sometimes not even linked to tissue damage – as occurs, for example, in headaches -, or it is triggered following illnesses or accidents, but does not resolves after healing. Chronic pain is estimated to affect two out of 10 Italians, who often don’t find an adequate response in medicine, because common painkillers don’t always work.
Science works to investigate the mechanisms that underlie these conditions – and which are not yet fully understood – and to find effective solutions. And in some cases it has been successful, as was the case with the triptan drugs which, introduced in the 1990s, changed the lives of millions of migraine sufferers (but they don’t work for everyone). For other forms of chronic pain, however, studies are still ongoing, while some conditions remain enigmatic. Among these, fibromyalgia, a debilitating disease recognized only in recent years, which causes severe muscle pain whose origin is completely unknown.