Why Is the Sensation of Pain critical to our wellbeing and how is CBD connected
What is pain and what does pain mean
Pain. Temporary or chronic, following an injury, a disease or some interruption in our nerves' activity, pain is not only an integral part of our lives, it’s also essential.
Pain has been with mankind from the dawn of humanity. It’s a sensation that, at some point or another, everyone experiences. Most often it will go away after an hour or so, but in other cases, it stays with us for longer periods of time.
Pain is critical to maintaining our health and critical to our wellbeing. However, sometimes, like with arthritis, pain increases to levels that might overshadow one's life.
As the medical world learns more about pain, so does the number of various methods meant to counter it increase. But there’s still so much to learn about this challenging, yet essential, sensation.
Pain escorts our lives from our first day to our last day on earth. It’s an important signal for our bodies that is meant to alert us about some mishap and signals us to rest and recover.
Some pain history
Humans have not always understood the importance of pain. In medieval Europe, it was believed that pain is punishment from God, and a way for redemption of our sins.
Throughout the years, many philosophers continued to come up with various theories on what exactly pain is, but the real breakthrough in managing pain happened only in modern days.
What is chronic pain and what is simply severe pain?
Pain can be short term and appears temporarily following some injury or disease. Usually, this type of pain will go away with the recovery. In other cases, pain can be chronic and last for months and years following some ongoing condition, a severe injury, or some inflammation that won’t go away. Such constant pain poses a real life-hurdle for the ones who experience it.
Pain is a common sensation that deeply affects our lives. In the US alone, as many as 50 million people report that they are suffering from chronic pain. Other research shows that as many as 40% of people’s complaints to doctors are regarding pain.
In a normal situation, pain sensation is the result of some damage that occurred to tissue in our body, and usually, the magnitude of pain will match the severity of the injury. The more severe the injury is, the more painful it will be. For example, the pain from a scratch is not as near to the pain resulting from a broken bone.
How are chronic pains and other types of pain processed by our body?
The information about the injury is received in dedicated nerve cells that are located in the skin, muscles, joints, and in most of our internal organs. These cells are called alarm cells or nociceptors.
There are a few types of nociceptors that are adapted to different stimulations. Some react to certain chemicals, others react to changes in temperature, and some react to extreme impacts, like strong pressure or traumatizing impact.
The information about the stimulation of those receptors is transmitted as electric signals from the injured area to the brain. Initially, the signal is encoded in an area in the brain called the thalamus, from which the data is transferred to advanced processing in some other areas.
The primary somatosensory cortex (S1), for example, is in charge of associating the pain with the relevant organ in the body, whereas the prefrontal cortex enables us to understand the meaning of the sensation. Other areas take part in processing the magnitude of the pain and its emotional impact.
Types of pain - 3 types of pain
- Nociceptive pain – pain that is the result of damage to tissues, like a broken bone or a burn, and its purpose is to alert from the continuation of the injury (like when you touch a hot surface)
- The other 2 pain types are the result of defects in our central nerve system.
- Neuropathic pain occurs when damaged nerves report pain in a way that does not clearly portray the damage that was caused to the tissue. Such pain is often described as a burning sensation, tingling, stinging, or electric current.
- Central pain occurs when the sensorial message that relates to pain undergoes a substantial enhancement in the brain. Such pain is typical to those who suffer from Fibromyalgia, for instance.
Pain management – what are some pain treatments?
Our body has embedded mechanisms to kill pain. As a reaction to pain, the pituitary gland secretes endorphins, hormones that are meant to block the message of pain and not allow it to get to the brain cells that will decode it and give it meaning.
These endorphins, therefore, bind to receptors that are present in nerve cells that are supposed to either transfer pain forward or to receptors that are supposed to receive the pain sensation. The result of that is that those substances that are required for inter-cell communication are blocked. Furthermore, endorphins trigger a euphoric sensation that helps us emotionally cope with pain.
Painkillers and Physical activity to ease pain
One of the most effective ways to stimulate the release of endorphins is intense physical activity. But such physical activity is not always possible depending on the severity of the injury. Sometimes the sensation that goes along with such physical activity does not provide a sufficient or proper answer to the magnitude of pain. In such cases, there’s no choice other to resort to painkillers.
The usage of painkillers has a long history. Ancient archeological artifacts that were found in Egypt of the Pharaohs indicate that already back then opium was used to kill pain. The medical use of opium was also documented in Europe in the 17th century. In the 19th century, ether and chloroform were introduced. Utilizing the two latter, allowed, for the first time in history, perform complex and long medical procedures.
Morphine – the chemical opium
The 20th century marked the introduction of morphine, which is chemically similar in its structure to opium and binds to those same receptors that endorphins bind to. Additionally, heroin, a drug made from morphine, proved to counter pain very efficiently, however, it was also found to be extremely addictive.
In the 80s, especially in the US, doctors started claiming that there is not enough evidence that opioids (opium-like substances – morphine, heroin, oxycodone, and other synthetic painkillers like fentanyl and methadone) are indeed addictive.
Therefore, the usage of those opioids increased substantially, and the rest is history – a nationwide medical crisis that had an immense impact on society. Between 1999-2017 nearly 400 thousand people died as a result of opioid-related implications, like overdosing. Therefore, in 2017 a nationwide emergency state was declared that was recently extended in 2021.
How do painkillers work?
Luckily, we have some other readily available options for painkillers that their intensiveness is far lower and give an effective answer to dealing with most of the daily common pain. Such medications are most often available OTC. The most renowned ones are those of the NSAID family, including ibuprofen (Advil, Nurofen) and Aspirin.
These OTC painkillers work by delaying the action of the enzyme named cyclooxygenase which produces prostaglandins, substances that are used to deliver the message of pain to the brain and trigger an inflammatory reaction.
Reducing the levels of prostaglandins decreases the level of pain that we feel and creates an anti-inflammatory reaction.
But still, such OTC medications cannot be abused since overusing those may cause bleeding and damage our kidneys and other organs.
Cannabis and CBD for pain
Cannabis was used thousands of years ago medically, amongst others to kill pain. There are documentation of cannabis usage as early as in the year 2900 BC in China, and in India in the year 1000 BC. Cannabis made its way to the western world much later, and it seems that only in the 19th century it began to be utilized to treat pain.
Among the active substances in the cannabis plant is the cannabinoid named THC. THC will bind to two receptors that are positioned on certain nerve cells. The binding of THC to one of those receptors that are within the nerve cells that acts to process the sensation of pain depresses their action and soothes pain.
Another unique quality associated with cannabis is the reduction of the inflammatory reaction in our bodies, and this also works to reduce pain. Remember, pain is a mere side effect of inflammation in this case. This calming effect is associated with CBD. CBD will bind to the receptor that is related to the sense of pain and affects how it works, and aside from reducing inflammation it also reduces and lowers the inflammatory reaction in the body.
Unlike THC which can get you high, CBD does not have any psychoactive reaction and will not get you high.
CBD for pain
Nowadays, after the whole legality of cannabis, or rather CBD, there’s an increased interest in consuming CBD against chronic pain, and, in fact, 17% of cannabis consumption in the US is for pain-related medical purposes.
However, as said many times before, due to the problematic legal status of the cannabis plant, serious scientific research could not be conducted, therefor still much research and clinical trial needs to be done for the medical community to fully adopt it as a legitimate means of treating pain.