Podcast 607: Is Pain the Enemy?

Pain is ubiquitous in the emergency department but it is not the enemy - suffering is

Nociception is the ability to feel noxious stimuli which usually causes a reaction, like pulling a limb away when you feel something painful. Nociception is really a brainstem reflex.

Pain is nociception plus cognition, meaning we process the noxious stimuli in our frontal cortex but it is not necessarily suffering.

Pain can be associated with euphoria, such as with distance running

Suffering, unlike pain, is associated with emotional distress

Nociception is a brainstem reflex, pain involves the brainstem and the frontal cortex, while suffering involves the brainstem, frontal cortex, and the limbic system attaching an emotional response

Providers should educate patients' expectations on pain as a part of the physiologic process and emphasize the focus on alleviating suffering