19 November 2008

BOPPARD, GERMANY - "Pain is an emotional reaction to an evaluation in one's head," said Ruediger Fabian, president of German Pain Aid, an organisation based in the town of Gruenendeich. Anyone can control this evaluation, he said.

The sensation of pain is subjective. As explained by Professor Rolf-Detlef Treede, president of the Boppard-based German Society for the Study of Pain (DGSS), sensory receptors send the signal to the spinal cord. The central nervous system then passes it on to the brain, which processes it in various ways.

"The brain has to decide what's important and what's not," Fabian noted. Pain is a protective device of the body, he said, and a pain stimulus on its way to the brain always takes priority over other impulses.

But a pain impulse can be stopped before it gets there, for example by medication. "Local anaesthesia prevents the pain stimulus from reaching the brain," Treede said.

More important, however, is how the brain processes a pain stimulus that arrived. "The brain can learn that a certain pain isn't so important," Treede explained. If someone scrapes an arm, he said, the injury often looks bad but the injured person knows it is harmless.

The brain can also grow used to pain, Treede said, "at some point it gets used to the hot cup of coffee in the morning, for example."

Through training, people can influence how their brains evaluate pain, according to Professor Walter Zieglgaensberger from the Max Planck Institute of Psychiatry in Munich. Pain sufferers need to take an active part in this process.

"The brain has no delete key," Zieglgaensberger said, noting that every pain leaves paths in the brain. After drug treatment, therefore, it is important that patients do things that they used to avoid because of pain, he advised. This causes the brain to replace old memories of pain with new, positive links.

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