We all know pain — but not all of us experience it the same way. For some, pain is sharp but fleeting; for others, it lingers long after the initial injury. A recent article, “Why Acute Pain Can Be So Intense for Some and Not Others,” by Christina Szalinski dives into the latest scientific insights into why pain can vary so dramatically from person to person. This newsletter is informed by the findings covered in her article.
Recent research suggests that the brain possesses an internal “volume control” for pain — a natural mechanism that helps modulate how strongly we experience it. When this system is functioning properly, it can dampen acute pain, helping the nervous system recover after injury. But when this regulation is disrupted, pain may linger and intensify, sometimes evolving into a chronic pain condition.
This regulation appears to involve projection neurons located in the medullary dorsal horn of the brainstem. These neurons serve as key messengers, relaying pain signals to other parts of the brain, including the parabrachial nucleus, which helps shape our emotional responses to pain. During acute pain, these neurons become less excitable — a change driven by an increase in the A-type potassium current (IA), which acts like a brake to prevent excessive signaling.
While further research is necessary to confirm these mechanisms in humans and develop safe, targeted therapies, these insights mark meaningful progress toward more personalized and effective pain management. Rather than simply blocking pain, the future may lie in supporting the body’s own ability to regulate and balance pain signals—opening the door to treatments that address the root of chronic pain.
For an overview of this topic, I invite you to watch the 3.5-minute video below.
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Reference
Szalinski, C. (2025). Why acute pain can be so intense for some and not others. Medscape. https://www.medscape.com/viewarticle/why-acute-pain-can-be-so-intense-some-and-not-others-2025a1000in2?ecd