Mapping The Brain's Landscape Of Pain

“For scientists, pain has long presented an intractable problem: it is a physiological process, just like breathing or digestion, and yet it is inherently, stubbornly subjective—only you feel your pain.”

So writes Nicola Twilley in this essay. But she then tells the story of an Oxford researcher named Irene Tracey, who has been making leaps in the field of pain research by subjecting test persons to various (very painful) procedures and observing their brains in MRI machines.

Twilley explains the history of pain research over the past century to end up at the current standard pain-ranking system on a 1-10 scale. Add the scale’s subjectivity to the subjective nature of outside observations of pain, which are always subject to personal bias, and you end up with a very nebulous system for definition and treatment. Researchers like Tracey are trying to better understand pain perception in order to lead to better pain analysis and management.

“Without a reliable measure of pain, physicians are unable to standardize treatment, or accurately assess how successful a treatment has been.”

This is why Tracey’s research is so monumental. One thing she showed early in her career was that anticipation and anxiety about pain may make it feel worse to a patient. She’s also helped understand how chronic pain is not necessarily the same process as “normal” pain that results from an external stimulus, but rather a malfunction in the part of the brain that receives pain signals.

Twilley also discusses the reasons why pain research is controversial. Pain testing has a number of legal and ethical risks—for one, when inflicting pain on another human is the basis of the research, how much should you have to justify the decision to do so? In other words: how much hurting is helping?