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How do we know where it hurts?

How do we know where it hurts?
6th June 2014

In order to deliver care in the appropriate way, carers of older individuals need to know when their patient is in discomfort. Therefore, it is absolutely necessary that they are able to identify where they are in discomfort, pain or when there is something that doesn't feel quite right.

Now, new research funded by the Wellcome Trust has sought to identify how exactly a person feels pain in a certain place on their body, returning some very interesting results indeed.

According to scientists at the institution, people's ability to ascertain a source of pain - called spatial acuity - changes depending on which part of the body is in discomfort.

They were able to look into this by causing pain to 26 healthy participants using lasers instead of physical touch. This enabled the investigators to map out how the spatial acuity was detected across the body in the volunteers.

"If you try to test pain with a physical object like a needle, you are also stimulating touch. This clouds the results, like taking an eye test wearing sunglasses. Using a specially-calibrated laser, we stimulate only the pain nerves in the upper layer of skin and not the deeper cells that sense touch," commented lead author Dr Flavia Mancini from the University College London Institute of Cognitive Neuroscience.

The results - published in the journal Annals of Neurology - showed the most sensitive areas to be on the forehead and fingertips, suggesting it is more likely people will be able to identify if the pain is being experienced in these areas. 

Discounting the parts of the hands which do boast hairs, the scientists generally found that a person's ability to identify their source of pain improved towards the centre of their bodies. However, when that pain was caused by physical touch, acuity improved at the extremities.

One of the most interesting factors was arguably that the experiment was also carried out on what was described as a "rare patient", who did not have a sense of touch but who could still feel pain like everyone else. The results showed this individual to display the same spatial acuity behaviours as the other healthy volunteers.

Speaking about what the scientists had discovered, Dr Mancini added: "This method offers an exciting, non-invasive way to test the state of pain networks across the body."

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