Dr. Peter Attia

And by the way, on visceral pain, what is the response to treatments with respect to the way we saw in noceptive pain where, hey, great response to these NSAIDs or opioids or whatever?

And by the way, on visceral pain, what is the response to treatments with respect to the way we saw in noceptive pain where, hey, great response to these NSAIDs or opioids or whatever?

Yeah, I was about to say, before you gave your examples, I was going to say nociplastic pain must be a huge bucket because it's everything for which we don't understand. It's sort of the all else bucket, which is enormous, especially for chronic pain, right?

Yeah, I was about to say, before you gave your examples, I was going to say nociplastic pain must be a huge bucket because it's everything for which we don't understand. It's sort of the all else bucket, which is enormous, especially for chronic pain, right?

Now, there's no objective way to measure pain, correct?

Now, there's no objective way to measure pain, correct?

Sorry, you're capturing these through what modality?

Sorry, you're capturing these through what modality?

Let's just start with standard understanding. If you put me into an fMRI machine and I said to you, hey guys, I'm not feeling any pain right now, I feel great. And then you scan me and then someone came out and took a hammer to my thumb and I went through the classic response that you described earlier, what would my fMRI show?

Let's just start with standard understanding. If you put me into an fMRI machine and I said to you, hey guys, I'm not feeling any pain right now, I feel great. And then you scan me and then someone came out and took a hammer to my thumb and I went through the classic response that you described earlier, what would my fMRI show?

And to be clear, this is distinct from the part of my cortex that is the homunculus for my thumb.

And to be clear, this is distinct from the part of my cortex that is the homunculus for my thumb.

Yeah. Okay. So let's go back to the story of these four branches of pain, or at least the first three, and then how the sensory component is impacting the perception.

Yeah. Okay. So let's go back to the story of these four branches of pain, or at least the first three, and then how the sensory component is impacting the perception.

Give me a little bit more.

Give me a little bit more.

Okay. So we go back to nociceptive pain. So tissue injury occurs. I think where I derailed us was in classifying all the different types of pain, but you had signal comes up, two signals coming up, the C fiber, the A delta fiber. The immediate response is to get you out of pain. There's an evolutionary logic to that. The C fiber is not there to get you out of pain because the A delta did that.

Okay. So we go back to nociceptive pain. So tissue injury occurs. I think where I derailed us was in classifying all the different types of pain, but you had signal comes up, two signals coming up, the C fiber, the A delta fiber. The immediate response is to get you out of pain. There's an evolutionary logic to that. The C fiber is not there to get you out of pain because the A delta did that.

Is the C fiber there to remind you not to go back and do that again? Perfect. Perfect.

Is the C fiber there to remind you not to go back and do that again? Perfect. Perfect.