On average, physical pain is not a pleasant experience but is necessary as a kind of warning light. Would a life without pain be better and is it possible at all?
“The body does not want pain – it only uses it as a means by which it tells us that something is not right and requires our care… If the body speaks to us in the language of pain, it tells us about a very important matter.”
JO CAMERON – A WOMAN WHO FEELS NO PAIN
After the hand operation she underwent when she was 65 years old, the doctors disbelieved that she did not need painkillers, which was unlikely to happen in similar cases. They sent her to geneticists who discovered extremely rare gene mutations that caused insensitivity to pain as well as lack of stress, and absentmindedness. It turned out that she never felt any pain, even during labor. She had never asked for painkillers before. She simply did not feel any pain and it seemed completely normal to her. Perhaps if it wasn’t for the hand operation, she would never have realized she was not like most people. She said she was happy, but she would have wanted a warning lamp to know something was wrong.
THERE IS NOTHING WRONG THAT WOULDN’T WORK OUT FOR GOOD
There are other similar cases when a man without pain walked with a broken arm, got burned, or was hit by a car and got up on his own. People suffering from congenital insensitivity to pain have limited ability to obtain information about their body’s needs and are forced to use other information, such as visual or physical observation of symptoms. In a family with this condition, a mother who is sensitive to her children’s disease has realized in time that her daughter’s hard belly may be a symptom of appendicitis. It turned out that she was right.
DO ARE GENES TO BLAME?
Congenital insensitivity to pain, so-called analgesia, is a condition that inhibits the ability to feel physical pain. Since birth, people affected by the disease never feel pain in any part of the body after injury. Interestingly, people with this condition may feel the difference between acute and dull, hot and cold, but they cannot, for example, feel that a hot drink burns their tongue.
The most common cause of the condition is a mutation of the SCN9A gene that affects the formation of sodium channels in the nerve cells called nociceptors (or pain receptors), which transmit pain signals.
The disease is inherited according to an autosomal recessive pattern, which means that both copies of the gene in each cell have mutations. Each parent of a person with an autosomal recessive pattern has one copy of the mutated gene, but usually shows no signs or symptoms of the mutation.
MULTIPLE GENES – THE SAME EFFECT
Not every case of insensitivity to pain is the same. The case of Jo Cameron was slightly different. She had two gene mutations, which caused the ‘suppression’ of the FAAH gene, which is responsible for the formation of the enzyme that decomposes anandamide, i.e. cannabinoid acting similarly to the active ingredients of cannabis. By having twice as much anandamide as the population average, she felt no pain, but it also affected her mood and made her forgetful.
A GOLD-WEIGHTED PATIENT
The disease is rare, however, it is only a case of dozens of diagnosed people. Since 65-year-old Jo Cameron was not aware of the disease, there are certainly more such people. A handful of patients are extremely valuable for researchers, as they provide information on the mechanism of pain generation, which in effect allows developing more effective methods of therapy for people suffering from chronic pain.
MAN LIKE A CAR
Unfortunately, people affected by insensitivity to pain live shorter lives on average. Children are particularly vulnerable, which is obvious. Imagine the lack of controls in the car. If you don’t know your car and don’t hear any suspicious sounds, you will eventually find out severely that it will refuse to obey.
Sources:
- https://bbc.com/news/uk-scotland-highlands-islands-47719718,
- https://hilo.hawaii.edu/campuscenter/hohonu/volumes/ documents/Vol06x04CongenitalInsensitivitytoPainwithAnhidrosis.pdf,
- Sternbach, Richard A., Congenital insensitivity to pain: A critique., Psychological Bulletin, Vol 60(3), May 1963, 252-264,
- https://ghr.nlm.nih.gov/condition/congenital-insensitivity-to-pain#inheritance,
- https://ghr.nlm.nih.gov/gene/SCN9A#conditions,
- https://rarediseases.info.nih.gov/diseases/12267/congenital-insensitivity-to-pain,
- Schmitt: The Nature of Pain with Some Personal Notes. “Nursing Clinics of North America”. December 1977 – Citation.