How Pain Works

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Two Views of Pain Close Window A. The big

picture. When you bang your finger, the signal starts at the very tips of nerve

cells, then travels to and up the spinal cord, and into a part of the brain

called the thalamus. The thalamus sends the signals out to several parts of the

brain, including those that control touch, emotion, physical reaction, and

memory. B. Up close. Pain signals are carried by two types of nerve fibers,

A-delta and C fibers. The A-delta fiber carries the first, sharp pain. The C

fiber conveys the dull, throbbing pain that follows. The signals travel through

the spinal cord through a dense array of nerve cells known as the dorsal horn.

The dorsal horn sends the signals up to the brain’s thalamus, which then

distributes them to many different parts of the brain.

Pain Signals Close Window A pain message travels

through the body from one nerve cell (neuron) to the next. The signal passes

down the axon of one neuron and must travel across a small gap called a synapse

to reach the next neuron. To transmit signals, the neuron releases chemical

messengers called neurotransmitters into the synapse between it and the next

neuron. The neurotransmitters attach to receptors on neighboring neurons and

allow the message to continue on its way. This process is repeated in rapid

succession between nerve cells throughout the body, up the spinal cord, and into

the brain.

How Pain Works

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Perhaps the best way to start thinking about how pain works is to imagine it

as a signal that’s sent to the brain. For example, imagine that your fingers

touch a hot burner on your stove. The signal starts at the ends of nerve cells

in your fingertips and travels up the nerve in your arm to the spinal cord and

on to the brain. The signal then makes its way to various regions of the brain,

some of which control thinking and emotion and others that control involuntary

reactions to pain. (See Two Views of Pain) The result is that you feel pain

and anxiety and you experience an involuntary response, such as increased

breathing, as you jerk your hand away.

At this very basic level, pain is really no different from any other sensory

experience: There’s a stimulus, a message gets sent through the nervous system,

and the spinal cord and brain react to that message. To better grasp the

complexities of the pain response, you need to look at the workings of the

nervous system.

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