Pain daily influences a person’s quality of life. A few years ago, I had the opportunity to be with leprosy patients in India. A leprosy patient, with perfectly normal skin tissue on the soles of his feet, can take a three-mile walk and return with foot ulcers. This week I took a three mile hike in the Colorado Rockies and returned without ulcers. Why? Textbooks from my house and a few notes by Dr. Paul Brand help illustrate the reason.
The pictures of color-coded feet show that the way a healthy person puts feet to the ground changes radically from the first mile to the third mile. If at the beginning your great toe is doing most of the work, by the end of the run your lateral toes and the lateral border of your foot will take over. Later the toe and heel will come down together. When you begin a long hike, you will start off heel-toe, heel-toe. But when you return you’ll be lifting your foot and setting it down as one unit – all adjustments having been made subconsciously.
It is not muscle fatigue that causes these subconscious shifts. Rather, pain cells from toes, heels, arches, medial and lateral bones are intermittently informing your brain, saying, “Ease up a little, I need some rest.” I was hiking along oblivious, since my brain assigns these functions to a subliminal control, but every spot in my body is constantly talking to each other. Even as I sit and type this, the pain cells in my hips, legs, forearms are frequently asking me to shift my weight around, and I reflexively obey.
Pain thus is always having a conversation in my body. It whispers to me in the early stages of damage: subconsciously, I feel a slight discomfort and toss and turn as I enter REM sleep in bed. It then speaks to me as danger increases: my arms and back grow tender and sore as I shovel snow off the sidewalk. Pain shouts at me when there is severe danger: blisters, ulcers, hematoma, bleeding – when damage breaks out and it forces me to change behavior immediately. Such pain shrinks time to the present moment. What matters to the pain system is that you feel miserable enough to stop whatever you’re doing and pay attention right now.
A leprosy patient has lost this incessant yet often subtle hum of intercellular conversation in the body and will walk without natural shifts of gait or adjustments to pain.
As I study pain and aim to prevent and treat it, I gain deep respect for the Creator’s wisdom.
Men of Hope, a few questions for you to ponder: Did anything you read above change your attitude to pain? Do you think it is appropriate to thank God for the pain network? What about some psychological parallels to physical pain – warning emotions such as guilt & fear – can these play a positive role in a person’s health in the same way physical pain does?
- Ackerman, Diane. A Natural History of the Senses. New York: Random House, 1990.
- Lewis, Thomas, M.D. Pain. New York: Macmillan Company, 1942.
- Brand, Paul, and Philip Yancey. Fearfully and Wonderfully Made. Grand Rapids, Mich.: Zondervan Publishing House. 1980.
- Lewis, C.S. The Problem of Pain