No Pain -- and Without a Warning System

Dec.13, 2006— -- Dr. Joshua Prager was amazed when he saw the pain-defying performer known as Zamora.

"He stuck a spike through his face -- through his mouth and it went right through his chin," said Prager, director of the Center for the Rehabilitation of Pain Syndromes at the University of California at Los Angeles. "It was fascinating."

Zamora, whose real name is Tim Cridland, specializes in sword swallowing, fire walking, sleeping on beds of nails and other feats that bring him none of the wrenching pain you might expect. Zamora claims his sideshow tricks are a feat of his mind, but he might be one of the rare people born without the ability to feel pain.

Scientists now might be a step closer to unraveling the mystery behind Zamora's sideshow and closer to finding a way to help the rest of us live life without the sort of pain we don't need.

It sounds nice, doesn't it? A life without aches and pain? But pain can be useful -- and life without it can be dangerous.

Pain warns us when a hot pan handle is threatening to burn our skin, or when the nail scissors have slipped and cut our tender fingertips. Gabby Gingras, who has the rare condition where she is insensitive to pain, was 5 years old when she appeared on ABC News' "Good Morning America" last December. Her parents revealed how scary life becomes when someone -- especially a child -- lacks the ability to feel pain.

"Pain teaches, pain protects, pain can save you from a lot of bad things in life," said Trish Gringas, Gabby's mother.

Without pain, Gabby was without that protection.

"By the time Gabby was 2½, she had been hospitalized and been injured multiple times," said Gringas.

So while taking away pain can be good sometimes, taking it away completely also takes away our self-defenses. Pain protects us from inflicting serious pain upon ourselves in the first place and from further hurting ourselves so that we can heal. But new research may unlock a way for us to keep the pain we need and live without the pain we don't need.

Gene Mutation Takes the Pain Away

Researchers have found a key mutation in one gene that robs people of their ability to feel pain, according to a study published in today's issue of the journal Nature.

Scientists still don't understand pain -- why we feel it at some times and not others, and why some people can tolerate different levels of pain. This research, which sheds a little light on the perception of pain, could send scientists on a path to find new and novel ways to treat it.

A team of researchers from across Pakistan and the United Kingdom launched their research into pain-free phenomena after getting to know a young street performer in Northern Pakistan who regularly walked on coals and pushed knives through his flesh but felt no pain. The child died shortly before his 14th birthday after jumping from a roof.

After the child's death, researchers found six otherwise normal children from three families. They also lived in Northern Pakistan and were all of the same Qureshi clan. None had ever felt any pain in any part of their bodies. They did not understand what pain felt like. All of them had gnawed their own lips and tongues as young teething children and had bruises and cuts. Many had unwittingly broken their bones.

After much prodding, picking and pressing, researchers found that each child could feel touch and temperature, but not pain. Their brains and bodies didn't react to painful stimuli the way you would expect a person to respond. They didn't flinch or wince, nor did the parts of the brain that usually react to pain show any interest in a sharp squeeze to the Achilles tendon.

Zamora and Gabby act the same way, according to doctors and parents. Both can tell when something is hot or cold or when some object gently touches their face, but neither recoils from a sharp poke in the eyeball. Young Gabby scratched her left eyeball so furiously that it had to be removed -- but she never knew it hurt.

When researchers looked closely at the genes of the Pakistani children, they realized that each child had a mutation in a gene known as the SCN9A that would normally hold the blueprints for a sort of pain receptor on nerve cells. That's basically a piece of the cell that would otherwise receive the message, "Hey, that really hurts." The mutation seems to take away a person's ability to experience pain.

Exciting Discovery, but Treatments Far-Off

The discovery is surprising because pain is a pretty complicated sensation. To realize that our ability to feel pain can be knocked out with one faulty gene is, well, a testament to how powerful and complicated our genes can be.

It's also exciting to think that, by studying this mutation or this gene, scientists could unlock a whole new world of healing.

"The more we can understand the genetics of pain, the more we can contribute to our understanding of why some people experience different levels of pain to the same stimulus," said Dr. Albert Ray, chairman of the board for the National Pain Foundation. "By learning about why some folks can't feel pain, it may lead us to better understanding those who can...and the more we learn, the better our choice of options on how to make life constructive for the person."

Indeed, the discovery "unlocks one key to the puzzle," said Prager.

However, science is a long way off from packaging this genetic discovery in a pill form.

"This would most likely have to be a sophisticated treatment, possibly knocking out genes," Prager said. "We are a long way off from this being a treatment."

This new research points to the specific mechanisms that would be the basis of pain, but scientists know that pain is a very complex biological phenomenon. Any tinkering with the SCN9A gene could cause other unforeseen problems. But, it is certainly something to be tested.

Any treatments might bring Gabby into a much safer -- though more painful -- world than the one in which she lives now.

Study May Also Offer Insight Into Autism

The finding has interesting implications for other disorders, not just pain problems. Some children with autism spectrum disorder, for example, seem to have "weird sensory processing," said Dr. Lonnie Zeltzer, director of the pediatric pain program at Mattel Children's Hospital at the University of Califronia at Los Angeles.

That is, autistic children have a certain immunity to pain. Parents of autistic children report that they can tear apart their skin and have accidents and feel nothing. But at the same time, autistic children can be very hypersensitive to some types of pain, like having their hair combed. It's an interesting phenomenon that researchers have recognized, but haven't studied -- yet.

"No one has looked at this genetic link to pain processing…but with this new finding, there lie new avenues for research," Zeltzer said.

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