Pain Explained

Words: Dr Mohit SANDHU

Ayurveda is one of the oldest of medical sciences with eight-plus canonical components and eighteen-plus specialities. Apart from the specialities, pain management is, by far, the most significant Ayurveda practice — for over 5,000 years.

As an Ayurveda specialist, I practice Ayurvedic pain management with agnikarma and vidhikarma.

Besides focused, also holistic, treatment, we, Ayurvedic doctors, learn about atma [soul] during our under-grad studies. We often thought, during that time, that the atma was the non-clinical study structure in the BAMS curriculum. What is fascinating is one can find the quintessential essence of the atmic-connect during Ayurvedic pain management and treatment.

Atma is a beautiful word. Some people consider it ‘ghostly.’ In Ayurveda, atma is the self-consciousness. You may also relate it to what regulates and initiates the functioning of the heart and brain during our embryonic development. This has been defined by Suśruta [800-700 BC], the great Ayurveda physician and surgeon, in a profound anatomical context.

After we are born, we all embrace the conscious, stage by stage. You’d call it age, or aging. Consciousness works with every single cell and tissue up until death. When you touch any hot, or cold, object, for example, it is your consciousness that ‘controls’ your cellular initiation towards the object, or you could, in a modern context, relate it to the workings of our nervous system.

The nervous system is fascinatingly interesting and everyone knows about it in a modern perspective. Ayurveda highlights the nervous system in the form of atma in a captivating manner.

Ayurveda tells us that when the atma gets connected to indriyan [sensory organs], it gets arth [subject to work] and forms pursha [humanoid intelligence]. So, when you touch any hot, or cold, object you feel pain — which modern science relates to our central and peripheral nervous systems. Charaka [150-200 CE] described pain physiology with great finesse — and, its significance as atma, centuries before medicine became modern medicine.

Every cell has its own cellular organelle; the organelles work together in collaboration, whether they are neurons, or any cell type, or organ in our body. Charaka defined the sequence of signals just as precisely as they go from outer sparshanindriyan to atma.

Perception Of Pain

The function of the pain sensory system is to protect the body and maintain homeostasis [balance]. It does this by detecting, localising, and identifying the potential, or actual, tissue-damaging process. Each spinal nerve conducts impulses from a specific area of the skin called dermatome and the somatosensory cortex, which is ‘mapped’ to correspond to areas of the body from where the source of pain may be interpreted in the brain.

During the process of sensing the pain, primary afferent nociceptors [unspecialized nerve cell endings] have two tasks. The first is to transduce — the process by which a cell responds to substances outside the cell through signalling molecules found on the surface of and inside the cell — a damaging, or potentially damaging stimulus, whether they are mechanical, thermal, or chemical into the code used by the nervous system.

The second task of the primary afferents is to transmit information into the central nervous system [CNS] for processing [Bahya tvacha/sparshanendriya to mana to buddhi to atma]. It is said that when communicated through karana [tools, or instruments], karta, i.e., atma, gets the realisation of karma, vedana and buddhi.

Mana [mind], buddhi [intellect], sense organs [dnyanendriya] and functional organs [karmendriya] are the tools [karana]. For the sensation of vedana, the tools are mana [mind] and buddhi [intellect].

Sense organs [dnyanendriya] and functional organs [karma indriya] play a major role. It is said that though the atma [soul] gets all the knowledge, or information, it relates to vibhu [spread all over] in effect. Yet, it cannot perceive knowledge until the subjects are perceived by their respective sense organs through the mind. For that, the mind has to be in constant touch with the sparshanendriya [skin].

In Ayurveda, sparshanendriya [skin] is spread all over the body, internally as well as externally. Every single cell and cell organelle has the cover of sparshanendriya. Our mind gets attached to every single cell to carry it to buddhi for further processing. After receiving this sensory input of every stimuli, whether they are good or bad, buddhi interprets it and ‘ups’ ahankaara in the said subject. This is why vedana is expressed by sparshanendriya sparsha and manasa sparsha.

Physiology Of Pain

Pain is an uncomfortable feeling that tells you something may be wrong. It can be steady, throbbing, stabbing, aching, pinching, or something else that may be described in a host of ways. Sometimes, it’s just a nuisance, like a mild headache.

In Ayurveda, pain is denoted as peeda, vedana, ruja, shoola, ruk, toda, bheda, vyatha, etc.

Charaka articulated that vedana should be prescribed for mana [mind] and deha [body], involving indriya [sensory organs]. Pain is not perceived in kesha [scalp hair], loma [body hair], nakhaagra [tip of nails], anna mala [faeces], and anna drava [urine].

There you are — for the perception of pain, the role of indriya, along with mana [mind], is extremely important.

Conclusion

“Every cell and every tissue consists of atma on its outer and inside surface with the interconnection of hrudya [heart] and mana [brain].”

Dr MOHIT SANDHU, BAMS, CAD [Dermatology], CAC [Cardiology], PGDAKS [Kshar Sutra], is a pain specialist [Agnikarma], anorectal surgeon [Kshar Sutra], consultant Supervisor- Fontana Veda, Brazil, Member-AAPNA, and Member-Colorama Ayurvedic Association, USA. He is, at present, a specialist Ayurveda consultant @ Medivan Ayurvedic Hospital, Gurgaon, India.

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