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Last updated: Fri, Jun 28, 2024
The adaptive value of pain leads to the concept that there is "healthy" and there is "pathological" pain. (The Adaptive Value of Pain.) The distinction is that healthy pain is pain that protects and guides you (like a stove-top burn), while "pathological" pain is pain which doesn't. If pain doesn't protect you, it is a pathology, a disease. There are practical problems with this idea.
One is that it often isn't possible to determine whether the pain is actually protecting the sufferer from a dangerous abnormality. That would only be possible if a doctor could positively conclude that there isn't some form of wound or abnormality that is causing the pain. Review In a Complex Body for a brief explanation of why this is so. Further examples occur throughout this text.
Another problem with the term "pathological pain" is that the pain system works in such a way that a healthy pain system can create pain that has no useful biological purpose. This is elaborated in the remaining two sections on pain physiology, Pain Science 2: Nociceptors and the Spine and Pain Science 3: Neuroscience and the Brain.
And finally, pain is not only aversive, it is harmful. Think of it as a biological tradeoff. When you burn your hand, you are uncomfortable, certainly, but you are also diverted from your goal (whatever it is that you were cooking on the stove top). If pain motivates you to rest, you lose the use of your body for some period of time. So there are benefits (healing, learning) and their are costs. Whether your pains are "healthy" or "pathological," there is still a cost to pain. This aspect of pain is not well-reflected in the dichotomy "healthy" and "pathological." Similar criticisms can be made of the proposed distinction between eudynia (good pain) and maldynia (bad pain). (See The Challenge of Living in Pain for more about the costs of pain.)