麻豆传媒

PAIN remains one of the most slippery concepts in physiology. We all experience it, but it is nearly impossible to define in any complete way. That鈥檚 because measuring it objectively or testing for it is nearly impossible. If you鈥檒l forgive the comparison, one could argue that we are closer to 鈥渙perationalising鈥� love than pain.

In Understanding Pain, Fernando Cervero, professor of anaesthesia at McGill University in Montreal, Canada, gives a remarkably lively tour of what we do know. Although the book is heavily rooted in neuroscience research, Cervero provides a rich and historical backdrop, and layers his explanations with colourful metaphors and relatable examples.

He also tours through all that we still don鈥檛 understand, including exactly what pain is and why it occurs. There are several different types of pain that appear to have different origins, functions and mechanisms. Sometimes we experience 鈥済ood pain鈥�, which has a protective element, 鈥渂ad pain鈥� as a consequence of injury or disease, or 鈥渃hronic pain鈥�, which exists for no apparent reason.

鈥淭here is much we still don鈥檛 understand about pain 鈥� including exactly what it is and why it occurs鈥�

How we measure pain is improving, but the best and most reliable method continues to be having sufferers score their own discomfort. Testing pain is a messy process and not for the weak of heart, and treating it is even trickier 鈥� it is difficult to target a drug if you cannot point to the offending issue in all cases.

Ongoing efforts to resolve these ambiguities are slowly helping to clarify the physiology of pain.

A recent shift in societal perception is good news for those who are suffering, Cervero says. That change in attitude, from a belief that individuals should suffer in silence to the idea that pain can and should be reported and treated, means it is now considered a 鈥渕ultidimensional disease鈥� rather than solely a symptom. Bringing pain out of the shadows brings the hope of new treatments, a reduction in shame and critically important scientific knowledge.

鈥淲e are moving in the right direction,鈥� Cervero says. Pain may be part of the human condition, but it is not one that must be accepted.