%0 Journal Article
%T Nature and Nurture of Human Pain
%A Inna Belfer
%J Scientifica
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/415279
%X Humans are very different when it comes to pain. Some get painful piercings and tattoos; others can not stand even a flu shot. Interindividual variability is one of the main characteristics of human pain on every level including the processing of nociceptive impulses at the periphery, modification of pain signal in the central nervous system, perception of pain, and response to analgesic strategies. As for many other complex behaviors, the sources of this variability come from both nurture (environment) and nature (genes). Here, I will discuss how these factors contribute to human pain separately and via interplay and how epigenetic mechanisms add to the complexity of their effects. ¡°Pain is inevitable. Suffering is optional.¡± (Zen Aphorism) 1. Nurture and Pain Pain perception (meaning not just physiological processing of nociceptive signal but rather conscious recognition and awareness of painful stimulus) can be modulated and modified (enhanced or abolished) by many ¡°environmental¡± factors including psychological and personality-related factors such as previous pain experiences, emotionality and cognition, somatization and catastrophizing, presence of acute and chronic stressful life events, fatigue, anxiety, fear, boredom and anticipation of more pain, as well as socioeconomic factors (e.g., social support, acceptance, incentives, education, occupation and quality of life). In addition, pain behavior is different among genders and ethnicities, and varies with age. In addition, some clinical and medical factors correlate with risk for increased severity or chronicity of many painful conditions. 1.1. Cultural Factors The experience of pain is one of the fundamental human senses and most ancient protective survival skills. However, the ways in which people express and treat pain change across time and origin and are influenced by cultural and social factors [1¨C4]. Although there are similarities in word descriptors among cultural groups, with the word ¡°pain¡± characterizing the most intense and unpleasant discomfort, the word ¡°hurt¡± characterizing less severe discomfort, and ¡°ache¡± describing minimal and bearable pain [5], cross-cultural differences in the copying styles and attitudes towards pain medication have been also noticed [6]. It has been suggested that ¡°people in Eastern cultures have higher pain tolerance than those in the West¡± [7, 8]. This assumption is partly caused by the fact that painful rituals and ceremonials are widely accepted in Africa, India, and Middle East, and they may reflect overall pain behavior as turning inward, private and
%U http://www.hindawi.com/journals/scientifica/2013/415279/