Could we live without pain?
“There are people that live without pain,” says Treede, a neurophysiologist at the University of Heidelberg. “They have been known for centuries to exist.” Insensitivity to pain, known as analgesia, can be caused by a group of rare genetic diseases. Yet being impervious to pain does not mean being impervious to injury. Those with the condition can easily burn themselves on a hot stove without realising, for example, and are prone to joint issues due to mechanical damage. To avoid overloading our joints, or to avoid resting our hand on a hot stove, we need nociception. This is our body’s alarm system, which warns us when the body is under threat of damage, and is interpreted by the brain as pain. Signals that activate the nociceptive system kick in before the threshold of damage to the body – it would be too late if the damage had already been done once the pain arrived. If the nociception system is disrupted, a person may not be aware of a physical threat, and serious injury can occur. Nociception and pain aren’t quite the same thing though. Pain is a subjective feeling, Treede explains, while nociception describes the processes of sensing actual or potential harm, and can be measured objectively. “So living without pain, I would rephrase it as living without nociception,” says Treede. “It’s very, very dangerous because you’re lacking this alarm system,” he adds. Unfortunately, people lacking it often suffer from shorter life expectancies as a result. So while pain might not be a welcome feeling, it’s your body’s way of protecting yourself from serious harm. Malfunctions in the nociceptive system can happen in the other direction as well, leading to unnecessary and chronic pain. “There’s increasing evidence that in a certain percentage of patients, pain persists beyond the normal healing of bodily damage so it’s not completely linked to tissue damage,” explains Treede. In fact, pain is currently the most common non-communicable medical condition in Europe. Chronic pain affects 19 % of Europeans, lowering their quality of life and affecting their livelihoods. In the EU and industry-funded IMI-PainCare project, Treede and his colleagues sought to improve pain management and drug development, and find novel therapeutic approaches for pain. Through various subprojects, the researchers profiled women with chronic pelvic pain, standardised the assessment of acute and chronic pain, and sought out biomarkers that can identify the pain relief effects of drugs. The project generated strong results, some of which were presented to policymakers during an event at the European Parliament, ‘The Future of European Pain Research’(opens in new window). Despite the prevalence of pain, there’s a reluctance to fund research into it, says Treede. This may be partly because there may not be as much money to be made. Depression and back pain are known to be the largest cause of loss of working hours. “Depression is now recognised as something real,” notes Treede. “Chronic pain is lagging behind.” Click here to find out more about Rolf-Detlef Treede’s research: Fighting the epidemic of pain