Hello, my name is Kirsty Bannister and I work at
the Wolfson Center for Age-Related Disease at King's College London.
The title of my talk is the descending modulation of pain,
and in order to consider how pain is modulated in a descending manner,
we will spend the first few slides considering pain descriptors.
We know the pain is unique,
which is to say that no two people will perceive
the pain of the noxious insult in the same manner.
This is because pain is not linear.
It is an entirely subjective experience,
and we can begin to understand why this is
the case when considering the definition of pain,
which was updated by the International Association for the Study of Pain in 2020,
as an unpleasant sensory and emotional experience associated with
or resembling that associated with actual or potential tissue damage.
This straightway tells you that the experience of
pain can be described along multiple descriptive axes.
Here I outlined two of them.
The sensory discriminative axis allows us to locate the pain and describe its intensity.
While the affective motivational axis relates to
the unpleasantness of the stimulus in the behavioral reaction that it evokes.
It's because of this second descriptive axis that
past or present issues such as fear or hopelessness or helplessness,
can lead one person to score a cut to the foot,
for example, much higher on the visual analog scale than their neighbor.
This is precisely why pain requires an individualized treatment approach.
Interestingly, the words that an individual uses to describe
their pain tells you a lot about
the main pain descriptive type that they are experiencing.
These may be separated by asking an individual how
intense is your pain versus how unpleasant is your pain?
Crucially, six keynotes were provided by IASP