Stubbing your toe is the perfect example of disproportionate pain. As your pinky collides with the unforgiving corner of your coffee table, it can feel as if your phalanx has just erupted through the skin of your toe, and yet five minutes later it’s basically fine. Given the intensity of feeling from such a minor ailment, it got us wondering: can pain kill you?
What is pain?
Humans are highly sensitive due to a complex network of nerves that runs throughout our entire body (the first-ever complete dissection of the human nervous system demonstrates how extensive it is). Packed full of danger-detecting nociceptors, our nerves can pick up on changes in temperature, chemical balance, or pressure, but the pain isn’t felt by those nerves, because pain is sensed by the brain.
When you stub your toe the pain isn’t actually in your toe. Pain is the result of the brain evaluating information, combining sensory information with expectations based on previous exposure to pain.
This means that when the brain produces pain, it chooses a location based on a “best guess scenario”. Usually, the brain gets it right, but sometimes it doesn’t, as in the case of referred pain that can tell you the ouchie is in your shoulder when actually it’s caused by something that’s gone wrong in the abdomen, for example.
So, if pain is essentially the interpretation of information by the brain…
Can pain kill you?
Pain itself can’t kill you, but its physiological effects can, and it will come as no surprise that it’s one of the louder symptoms of a range of potentially deadly illnesses and injuries. Viruses are one example here.
“When you catch a virus, your immune system reacts to protect your body. It initiates inflammation – and pain is one of the cardinal signs of this inflammation,” Dr Franziska Denk, a senior lecturer at Kings College London who focuses on pain research, told IFLScience.
“Pain is caused by nerves in your body sensing that your immune cells are active and thus that your body is under attack. The nerves react by sending signals to your brain to encourage you to rest and not move about too much until the immune system has done its job and the inflammation has resolved.”
Aside from the underlying illnesses or injuries that cause severe discomfort, pain can also contribute to a person’s risk of death because of the stress it puts on the body.
What pain does to the body
“Severe pain is a horrific stress,” wrote Forest Tennant in Practice Pain Management. “Severe pain flares, acute or chronic, cause the hypothalamic-pituitary-adrenal axis to produce glucocorticoids (cortisol, pregnenolone) and catecholamines (adrenalin and noradrenalin) in an effort to biologically contain the stress. Catecholamines have a direct, potent stimulation effect on the cardiovascular system and severe tachycardia and hypertension result.”
Pain flares like this can push a person’s heart rate up to over 100 beats a minute and cause dangerously high blood pressure, which is especially devastating in patients with existing health issues, and it can be pushed even higher by another side effect of extreme pain.
“In addition to adrenal catecholamine release, pain flares cause overactivity of the autonomic, sympathetic nervous system, which add additional stimulation to catecholamine-induced tachycardia and hypertension,” Tennant continued. “The combined physiologic effects of excessive catecholamine release and autonomic, sympathetic discharge may put such strain on the heart to cause coronary spasm, cardiac arrhythmia, and sudden death.”
So, while pain itself isn’t a direct cause of death, it can have a significant influence on a patient’s outcome if it isn’t managed properly. Fortunately, the field of anesthesia means we can block even extreme pain, allowing surgeons to cut people open without them having to feel a thing.
But as far as stubbing your toe in the shower goes? You’re going to have to brave that by yourself.
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