Studies suggest that about 10% of one’s nervous system is dedicated to sensing pain. Given what else the nervous system does—sight, smell, taste, hearing, thinking, moving, digestion, etc., etc., etc.—that’s a lot!

Why so much attention to pain? As it turns out, there are benefits to feeling poorly.

Pain for Gain

Foremost is survival: without unpleasant sensations, we wouldn’t know to avoid fire, allow injuries to heal, attend wounds such as broken bones or cuts, etc.

There are additional ways in which negative feelings lead to have positive consequences.

Pain facilitates pleasure by providing an important contrast for pleasurable experiences, increasing sensitivity to sensory input, and facilitating self-rewarding behavior.

Pain augments self-regulation and enhancement by increasing cognitive control, reducing rumination, and demonstrating virtue.

Pain promotes affiliation by arousing empathy from others, motivating social connection, and enhancing group formation.

Pain Reduction

But for all of that, we try to avoid or minimize feeling bad. Indeed, pain is the most common reason why people seek medical care. Seeking relief is not a new phenomenon, but getting it is.

Surgeons have been using general anesthesia in the Islamic world for nearly two thousand years. In the 1600s, many European doctors gave their patients opium to relieve pain.

The earliest European surgeons operated while keeping patients wide awake and physically restrained. By the 1800s, the nicest surgeons introduced ether and chloroform anesthetics for surgery. And why was this controversial?

Several major religions view physical suffering as intrinsically linked with atonement or moral goodness. Some, such as Buddhism and Taoism, hold that it is caused by an imbalance within the individual and can only be resolved through personal effort. Others, such as Christianity, have historically believed that suffering brings one closer to an ideal spiritual state.

Some doctors questioned the ethics of operating on unconscious patients. Others were concerned that relieving pain might hamper healing. “But the surgeons could not long resist their new power to perform longer and more complex procedures, and most patients thought anesthesia a divine blessing,” wrote Marcia Meldrum, an associate researcher in the department of psychiatry and biobehavioral sciences at the University of California, Los Angeles.

By the 1900s, people were using morphine and heroin as pain medications. At first, doctors thought these “safe.” However, over time, it became clear that these treatments also made people vulnerable to addictions.

Until this time, the medical field considered pain to be primarily a problem to manage in acute care (related to injury, for example, or surgery) or during a painful death from cancer.

“Flavors” of Pain

Acute pain is what you feel when you become hurt or injured. You may have experienced acute pain from an injury such as a cut or a broken limb or from disease or inflammation in the body. Acute pain can be intense and severe, but it typically resolves as your body heals from whatever caused it.

Nociceptive pain is caused by tissue damage. Most acute pain is nociceptive. 

According to NIH, chronic pain is a sensation that lasts much longer than acute pain―usually months and sometimes years. Chronic pain sometimes has a clear cause, such as an acute injury, a long illness, or damage to and dysfunction of your nervous system. However, it sometimes happens without any obvious reason.  Medical providers have often assumed that patients complaining of on-going pain are delusional, hypchrondiacal, malingering, or addicts. Patients often turn to psychotherapy, or sometimes neurosurgery.

Neuropathic pain is caused by nerve damage or dysfunction. You can experience neuropathic pain from injuries or illness that affect the spinal cord and brain (for example, a slipped disc in your spine) or the peripheral nervous system (the nerves throughout the rest of your body). This kind of discomfort often feels similar to burning, shooting, or stabbing. 

Inflammatory pain happens when your immune system activates in response to injury or infection. In addition to causing redness or swelling, it can also make you more sensitive to feelings of pain.

Everyone’s pain feels differently, and the only way to know whether someone is hurting is to ask. Has a medical practitioner asked you to rate your discomfort on a scale from 1 to 10? They may also ask you to describe what you feel: dull, throbbing, aching, shooting, stabbing, etc.

Treatment Options

Just as there isn’t a way to measure it objectively, there isn’t one single treatment that will work for everyone. It often involves a combination of treatments, which may include:    

• Over-the-counter and prescription medications (such as pain relievers and drugs that reduce inflammation)
• Physical and occupational therapy to improve function and limit discomfort
• Counseling and therapy to teach skills for coping with pain
• Medical treatments (such as medications and injections) to interrupt the brain’s signals or change how nerves process painful sensations 
• Neuromodulation therapies (devices that stimulate nerves or the spinal cord) to reduce pain 
• Complementary and integrative therapies (such as acupuncture and mindfulness meditation). 

And When Nothing Helps…

Chronic pain is an enormous problem.

More than 1 in 5 adults in the United States experience chronic pain.  Chronic conditions, such as low back pain and migraine, are the leading causes of disability around the world.

Not surprisingly, rates of chronic pain, including conditions that severely limit work or life activities, are highest among adults ages 65 and older.

In the 1980s, several prominent pain specialists suggested that opiods had a “low incidence of addictive behavior.” They pushed for increased use of the drugs to treat long-term, non-cancer pain, as Meldrum noted in her paper “The Ongoing Opioid Prescription Epidemic: Historical Context.” Today we all know how wrong they were, and we are still trying to undo the opioid crisis.

Where Does Aspirin Come From?

Apart from prescription medications, over-the-counter options are popular. Aspirin, as it is known today, was first developed in 1895 in Germany. By 1915, Bayer Pharmaceuticals developed the first tablet form, which they then sold throughout the world as a medicine.

The active ingredient in aspirin is acetylsalicylic acid, which is formed by the acetylation of salicylic acid, which is derived from natural plant sources such as jasmine, willow and poplar trees, as well as certain species of legumes.

This gives credence to the efficacy of willow bark tea for minor aches and pains, as long claimed by folk medicine practitioners.

However, aspirin is no longer made from willow bark. Today, pharmaceutical companies derive aspirin from plants of the Spiraea genus. Compounders then convert the salicylic acid into acetylsalicylic acid via acetylation.

Aspirin is very useful in many ways besides pain relief. Indeed, doctors use it as a blood thinner to treat clots. At a daily dose of 81mg, it is helpful in preventing future heart attacks.

But beware: You should not use aspirin if you have a bleeding disorder such as hemophilia, a recent history of stomach or intestinal bleeding, or if you are allergic to an NSAID (non-steroidal anti-inflammatory drug) such as Advil, Motrin, Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.

OTC Alternatives

A common alternative to aspirin is Tylenol. Acetaminophen, commonly sold under this brand name, is a non-opioid analgesic that relieves pain and reduces fever. Acetaminophen regulates the body’s temperature and alters its perception of pain.

Tylenol is generally safe at recommended doses. For adults weighing more than 110 pounds (50 kg), the recommended acetaminophen dosage is 1000 mg every six hours or 650 mg every four hours.

Risks

However, elderly individuals may face higher risks of certain side effects due to physiological changes, including:

• Liver Damage: Aging decreases liver efficiency. This raises the risk of liver damage from acetaminophen, especially if taken in high doses or with alcohol.

• Kidney Damage: As kidney function naturally declines with age, long-term or high-dose use of acetaminophen may lead to kidney damage in the elderly, particularly if their kidneys are already compromised.

• Gastrointestinal Issues: Although Tylenol is easier on the stomach than nonsteroidal anti-inflammatory drugs (NSAIDs), it can still cause gastrointestinal discomfort. This may include nausea, constipation, or diarrhea.

• Acetaminophen toxicity occurs when a person takes more than the recommended dosage of this medicine. Tylenol overdose leads to 56,000 emergency department visits, 2,600 hospitalizations, and 500 deaths each year in the United States, making it one of the most common poisonings. Too much of a good thing is not a good thing!

Apart from any hedonistic motives to “just feel good,” pain is an economic drain: the estimated yearly national cost of pain, including medical treatments, disability, and lost productivity, is $560 billion to $635 billion in the U.S. alone!

Bottom Line: Pain is universal, and treating it is only human. But proceed with caution!