Pain Perception Of Pain

Abstract
Pain, especially chronic non-cancer pain, can significantly affect patients’ quality of life not only because such pain can impair individuals’ activities, potentially leading to disability, but also because it can cause social relationship problems, loss of productivity, and comorbidity with various mental disorders. Pain is also an important topic in the health-related industry because it places an enormous economic burden on our health care system. Therefore, it is pivotal to understand the individual difference in pain experience, which can translate into clinical practice. Pain is a nociceptive sensory experience; thus, it can be fully influenced by our emotions, cognitions, and beliefs. In this paper, I discuss pain, pain perception,

Pain perception involves not only the ascending pathway but also the descending pathway. The ascending pathway is the bottom-up process starting with the nociceptive sensory information that is transferred to the brain through the spinal code while the descending pathway is the top-down process starting from the brain to sensory body parts through the spinal code. Melzack proposes to explain pain experience by the neuromatrix theory as “a complex, multifactorial subjective experience” produced by a widely distributed brain neural network (Melzack, 1999; Tracey & Mantyh, 2007). In other words, the neuromatrix (an integrative neural network) integrates the inputs of all factors of the individual such as sensory information, emotional distress, stress, moods, memories, genetics, etc. and generates the outputs of his or her pain perception (Melzeck, 2001). Thus, pain perception involves wide brain regions that primarily include subcortical structures (e.g., the hypothalamus, the amygdala, the thalamus) and areas in the cortex (e.g., the primary and secondary somatosensory cortex (S1 and S2), the insular, the anterior cingulate cortex, the prefrontal cortex (Goldstein, 2016; Apkarian et al., 2005). In addition, other brain areas such as the hippocampus and areas within the parietal and temporal cortices can also be involved in pain perception, dependent on situations of each individual (Tracey & Mantyh,