Primary and secondary pain

The “classifiers” distinguish between primary and secondary pain. The latter arise as a result of damage in the place where we feel pain, and the firsts appear without us detecting anything relevant where it hurts.


There are primary headaches (migraine, tension headache ...) and secondary (tumor, hemorrhage, bump ...).


Primary pain is supposed to have origins, even when they aren’t tangible. Migraine, they say, arises from some genes that build hypersensitive cerebral generators of migraines. Tension headaches are generated by states of anxiety, nerves that contract muscles excessively. Primary pain is actually secondary. The pain comes from something. That’s what the patients always say.


It’s not clear whether the "spine" pain is primary or not, without a tangible cause. If something hurts, it’s taken for granted that one’s lower back or neck isn’t well. Mechanics, loads, physical effort, postures, wear, years are what matter. The "bone pain", depending on the point of view, is primary or secondary.


- My bones ache ...


The statement stands for itself. It could be a primary pain derived from the condition of the bones, which is hurting themselves.


- The bones don’t hurt ...


If one wants to lose the confidence of the patient, all he/she has to do is that staggering claim. However, it is so. Bones don’t hurt. The pain may arise from harmful events of the bones, events that generate neuronal signals that reach the brain areas able to project the perception of pain in the conscious display of the individual. The "bone pain" would, therefore, always be secondary.


- When the weather changes, my bones can feel it.


Time is to the bones the same as nerves are to the head. The primary headache would be secondary to the overwhelm, and the primary bones would be secondary to the cold and damp.


Something similar happens with discouragement. Depression can be primary, without an apparent reason, or secondary to a depressing event. Psychiatrists prefer to call the primary endogenous and the secondary exogenous.


I've never understood the difference between endogenous-exogenous or primary-secondary. What is perceived is always the result of a complex cerebral evaluation process. There is always a decision of the network.


- I have a primary pain for no reason. They say it’s the brain, which has its reasons to turn it on, but I don’t know them. The MRI is normal. There really is no reason. The brain is wrong.


- Exactly. The primary pain is a secondary pain to an erroneous cerebral evaluation.


There are primary and secondary people. A primary person is someone we can see without there being a person. If we take a picture of where we see them, they don’t appear in the picture. A secondary person is the one we see for the simple reason that he or she is really there. He/she is in the picture.


- A hallucination?


- Yes.


There is primary pain in the absence of states and agents that activate the nociceptor network. We are sorry, but on the area of the disease there is nothing relevant, harmful.


- A hallucination?


- Technically it is a hallucination, but don’t go around saying that...


Pain without harm, hunger without malnutrition, cold without low temperature, loneliness in a crowd ... are primary. The necessary and sufficient objective condition to be explained and understood is not given.


I don’t like the classification of primary-secondary, endogenous-exogenous. I prefer to distinguish between perceptions-right productive choices, and wrong-unproductive.


There is pain, discouragement, cold, hunger, dizziness; unnecessary, disabling, sterile, pure pathological tiredness. They are secondary to an erroneous assessment of relevance-probability, that is ... primary, as “classifiers” claim.


There is pain, discouragement, cold, heat, hunger, tiredness ... that are necessary, convenient to guide the behaviour of the individual in the right direction. Secondary, exogenous, justified ...


The content of what is perceived does not guarantee its objectivity. There may not always be people where we see them. People may not always be where we see them. The MRI may always be normal wherever we feel pain.


- There is a threatening man in the living room.


- Let's see ... There’s no one. He’s a primary man...


- What do I do? What do I tell him to go away?


- Don’t pay attention to something that doesn’t exist. If you do so, you’re lost.


Checking account balances are sometimes negative. Classifiers distinguish between the primary negative, which appears without one finding the reason for it, and others that arise after a lavish expenditure.


Negative checking accounts express the balance between what goes in and out over time. The usual expenditure is enough for the alarm to go off, without us getting any benefit from it.


The brain manages our account. It doesn’t need to run out of money. If it considers that we shouldn’t spend it, it blocks our account without further explanation.


- I’ve been feeling discouraged lately. I don’t get it, everything is right ...


- Everything hurts, always, and they can’t find anything.


The primary is that way... Homo sapiens (ma non troppo) is perhaps a more primary species than we think ...