Pain Free People and Central Pain

After more than one comment and request, we publish on the topic of those who feel no pain.


Pain Free, Why Not Me?

One of the most common suggestions from well meaning relatives is to find those who feel no pain, find out what is going on in them, and then try to mimic it to help Central Pain. Easier said than done. Still, because so many have asked about it, we include some information here. Considering that there are a number of steps in the pain cascade, there should be numerous genetic causes possible, not just one, and that is seen to be the case.

First, we should point out that we are not envying these unfortunate people. Because they cannot sense pain, joints are maintained in what would be a painful position, or malposition, and the children typically die by around age 22, sometimes much younger from joint infections or fractures. A few of the pain insensitive syndromes have mental retardation or failure of the autonomic or “automatic” nervous system.

Apparently, others have had the same idea about the pain free, since the venerable central pain researcher, David Bowsher, has reported on one family with congenital pain insensitivity. In some circles, it is de rigeur to classify on whether the insensitivity includes the autonomic system or not. Where this is done, the naming usually begins by what MIGHT be missing and then typed according to what IS missin. For example, HSAN V, which means Hereditary Somatosensory Autonomic Neuropathy-type 5. Experts will understand by this naming what the patient’s symptoms are, as opposed to other hereditary sensory neuropathies. As you will see, SOME of these clearly have a central factor, and THEY would be the most likely candidates to help understand Central Pain.

In Dr. Bowsher