Why Do Small Wounds Hurt More Than Big Ones?

You catch your little toe on the bed frame and end up doubled over by something that leaves no mark by morning. That same evening you find a long scratch down your forearm and have no idea where it came from. The size of a wound and the volume of the pain have nothing to do with each other. They come apart every day, in everyone. Three out of four badly wounded soldiers turned down morphine. A builder screamed in agony with a nail through his boot, and his foot turned out to be untouched. A man who lost a leg feels a cramp in it for years, one he can't stretch out. Pain can't be measured by any instrument. There's no unit for it and no test that shows anything. In a hospital, even in the worst cases, it comes down to one question: on a scale of one to ten. This is about who sets the volume — and why it isn't your body. SOURCES: Melzack R., Torgerson W.S., "On the Language of Pain", Anesthesiology, 1971 Melzack R., "The McGill Pain Questionnaire", Pain, 1975 Beecher H.K., "Pain in Men Wounded in Battle", Annals of Surgery, 1946 Melzack R., Wall P.D., "Pain Mechanisms: A New Theory", Science, 1965 Fisher J.P., Hassan D.T., O'Connor N., "Minerva", BMJ, 1995 Bingel U., Wanigasekera V., Wiech K., Ni Mhuircheartaigh R., Lee M.C., Ploner M., Tracey I., "The Effect of Treatment Expectation on Drug Efficacy: Imaging the Analgesic Benefit of the Opioid Remifentanil", Science Translational Medicine, 2011 Woolf C.J., "Evidence for a Central Component of Post-Injury Pain Hypersensitivity", Nature, 1983 Raja S.N. et al., "The Revised International Association for the Study of Pain Definition of Pain", Pain, 2020 National Center for Health Statistics, data on chronic pain prevalence in adults, 2019 #pain #brain #neuroscience #psychology #medicine #darkpsych