"No Pain, No Gain": Congenital Analgesia, Its Causes, and Its Relations to the Input/Output Theory

JaymElaine's picture

Congenital analgesia is a rare condition in which children, usually from birth, do not sense physical pain coming in from outside stimuli. Children with this rare condition often times break bones, lose teeth, get many cuts, bruises and bites without the body even knowing, and this can potentially dangerous, for the obvious reasons. Those who experience congenital analgesia can still feel touch, sensation, and normal body-to-body contact, which tells us that the brain can receive some information filtered through the nervous system; however, when it comes to extreme temperature changes, or any bodily damage that signals the body to react in an emergency fashion, the body instead does not respond. (1) This is a scary thought indeed, for only a very small percentage of our neural connections actually deals with communicating with the outside world, and because there are so few it seems as if we would need all of them! In the case of those with congenital analgesia, the input is either not being perceived or the input is being perceived, but the body knows no matching output.

Upon reviewing some notes taken some weeks back, I noticed where I was having trouble with the idea that the body receives inputs and the body produces outputs, but that they can either be in relation to one another, or be completely independent of each other. As a biology major, I was taught that for every action, there is a reaction; for every stimulus, there is a response; and for every thing that you put in, you can always get it back out. But I see now, that this is not always the case, as in the case of congenital analgesia. There are two sub-divisions of this condition: insensitivity to pain and indifference to pain.(1) Those who have an insensitivity to pain cannot interpret harmful input; those who have an indifference to pain can interpret the harmful input, but cannot match/pinpoint an output. These notions further explain how inputs and outputs can co-exist or work independently, especially in the case of pain indifference, where inputs are surely coming in, but outputs are not coming out.

Congenital analgesia, an autosomal-recessive trait, has been linked to a mutation in the SCN9A gene. (1, 2) Any slight mutation of this gene makes it completely non-functional, disabling the brain’s ability to interpret input pertinent to health. More scientifically, the SCN9A gene is important for encoding the alpha-subunit of the voltage-gated sodium channels, which are responsible for assisting in action potentials and signal firing amidst our neural connections in the body and brain. (2) Experiments done by Cox, et. al, shows that SCN9A, when mutated, produces sodium channels that do not function well, resulting in a decreased signal firing rate, whereas in wildtypes whose SCN9A gene was normal, the sodium channels assisted in action potentials and signal firing was normal.

Knowing about congenital analgesia, its causes, and its relationship to the input/output theory that we discussed in class can be quite beneficial to us in future research, for example we can create medicines to dramatically increase pain inhibition in such as cases as war or painful disease. However, the new question that I pose to my readers is now that we know about congenital anakgesia, it causes, and its relationship to the input/output theorem, how can we further use such a rare condition to our benefit, and what would Emily Dickinson have to say about this condition? According to her, it is all in the brain, it is a construct of our brain; but is it really?

References Cited

(1) “Congenital insensitivity to pain” http://en.wikipedia.org/wiki/Congenital_analgesia

(2) Cox JJ, Reimann F, Nicholas AK, Thornton G, Roberts E, Springell K, Karbani G, Jafri H, Mannan J, Raashid Y, Al-Gazali L, Hamamy H, Valente EM, Gorman S, Williams R, McHale DP, Wood JN, Gribble FM, Woods CG. An SCN9A channelopathy causes congenital inability to experience pain.2006. Nature: 444, 894-898

Comments

Serendip Visitor Beth's picture

I dont flinch

I experience pain but I rarely respond to it. I have had more surgery than Joan Rivers (not to my face) and have had to take pain medications but if I am kicked by a horse (I am a professional horse trainer) or some other violent blow occurs I know it has happened but I don't respond. I have suffered massive blows to my body and it is almost like things slow down and everything becomes clear and I can continue with what I am doing without flinching. I have been aware of this most of my life and people are quite disturbed when they observe this. I was struck in the face by a horse and it broke me nose to the left side of my face. It was excruciating but I leaned on the gate and straightened it myself. You can see in photos the difference in its appearance.

Has anyone heard of such a thing before?

Beth

Michelle Adams's picture

Congenital Analgesia.

I am a Sophomore at Tonopah Valley High School, and in my biology class we've just started anatomy and the bodys' systems and how everything works. We started with the Nervous System. I plan to become a neurosurgeon, so this was very interesting for me. I asked my teacher what it is called to not feel pain and he didn't have a clue. So reading this information and knowing that this is something I can share with him and knowing one thing he doesn't makes me extatic to have been able to read this. I do however have one question; Could this have anything to do with the Fight or Flight response mechanism?

Stephen (guest)'s picture

Congenital Analgesia

I too am a sufferer of chronic pain and have the same interest as Tim. Has there been any progress in the use of this knowledge to ease the suffering of those with chronic pain? I feel great sadness for those afflicted with this condition and hope there is some progress in finding a treatment for them. I myself have been on too many medications for far too long and the meds are causing some not too pleasant side effects that I either deal with or suffer the pain. If there were some information available that could assist us, please share. We would all be very grateful.

tim's picture

pain sufferer

As someone who suffers from chronic pain I wonder has there been any use of the knowledge about this terrible condition that could bring some release of the pain that I and others like me have?

Writer's picture

Congenital Analgesia.

Those interested in this subject might be interested in this novel about an adult who copes well with the condition.

http://www.amazon.com/​Freak-Show-Case-Pegasus-Investi​gations/dp/0615515541

Jerry Daumer's picture

congenital anangesia

I have not been able to feel pain past a minimul level since I can remember. Until recently I did not know that I was not alone in this matter.example: I was riding in the back of a VW micro-bus with a soft top. It went sideways on an icy bridge and rolled. I went through the roof and landed quite a ways down the road and the grassy side. The VW then run over me fromcrotch to shoulder. I then got up and walked away. I felt no discomfort at the time. At the hospital the other 5 people were examined first as I was in a good mood., this almost cost me my life. I was black from below my waist to my shoulder. My only treatment was a cathiter and two IVs. I was discharged in 10 days.

Austin's picture

scriptwriter

Jerry, I would be glad if we could be penpals for a short while, mostly because I am writing a script about a person who has congenital insensitivity to pain, like you. Just write me back, I would have a couple of questions.
I appreciate it.

Thanks

Austin

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