The Brain Behind Pain

One might think working as a physician would lead to disrespect for the human body. After all, mostof the bodies we see are broken or malfunctioning in some way.In my case, however, the opposite is true. My practice as a pain specialist (particularly chronic pain)has drawn me into areas beyond the usual options for medical treatment. In the process, that has ledto a fascination with the human brain and its myriad properties.I think it's safe to say that most of us take our brains for granted. If we think about them at all, it'sin terms of comparative mental accomplishment (in our prime of life) or dysfunction (beyond ourprime). Rarely do we stand in awe of all that this eight-pound organ does for us.With this book, I'm hoping to do my part to change that. The focus is on the brain's relationshipwith pain, but discussing that opens a door to broader considerations. Meanwhile, the potentialreadership is literally universal -- all of us have brains, and almost all of us (except for those with arare condition described in the book) have felt pain.What most of us may not realize is that research into the causes of pain began thousands of yearsago. The ancient Egyptians pondered the question, and Greek philosophers such as Aristotle, Plato,and Galen made it an important part of their overall philosophies. Hippocrates was laying thefoundation for modern brain and pain study as early as the late fifth century and other scientificicons, such as Rene Descartes and Charles Sherrington, built on what he had discovered andpostulated.By the 20th century, some new revelation about pain and its possible treatment was being reportedin the scientific journals nearly every month. That has only accelerated over the past few years,which makes the study of the brain and pain one of the livelier medical specialties.Meanwhile, there has been a significant change in the attitude toward pain by 20th centuryphysicians, researchers and hospital personnel. Previously, pain was simply linked to whatevercondition might be afflicting a patient, leading to the belief that when that condition was cured ormanaged, the pain would automatically disappear.Now, though, it has become apparent that pain might be more than just a symptom. In some cases,it becomes a condition all to itself.Since pain is literally a product of the brain, which announces it after being warned by a small armyof nocioceptors stationed throughout the body, it is also open to glitches in that process. Chronicpain often occurs when the brain "remembers" pain, even though the condition that caused it mayhave been dealt with.This book has a clinical core, but I have broadened the scope to include not only research historybut touch on several peripheral issuers involving pain. That includes a chapter on masochism andcongenital insensitivity to pain, another on the opioid epidemic.