A Life Without Pain: A Look Into Congenial Insensitivity to Pain

For most people, pain is a large part of their lives. While many people try to avoid it at all costs, its experience is almost inevitable. In many ways, pain controls the way we live, driving us to be more cautious and take better care of our bodies. Yet, to some individuals, the sensation of pain is a completely alien concept, one which they have never experienced and likely will never experience. These people are afflicted with a genetic disorder, known as congenial insensitivity to pain. Said disorder prevents the individual from experiencing any physical pain, even when experiencing severe injuries. While a life without pain may sound like a blessing, those who actually experience it tell a different story.

Typically, humans will experience two distinct types of pain: nociceptive pain and neuropathic pain. Nociceptive pain occurs due to the activation of “nerve fibers” located throughout the body. This type of pain is typically brought about through injury of a body part, and normally goes away if the injury is healed. There are two types of nerve fibers which control nociceptive pain: “fast” nerve fibers which deliver a sudden, sharp pain, and “slow” nerve fibers which deliver a gradual, burning pain. The “fast” fibers serve mainly to alert the body to the presence of pain, while the “slow” fibers serve to determine the intensity of the pain. Neuropathic pain, on the other hand, stems from alterations made to the nervous system which induce a sense of pain. This frequently results in chronic sensations of pain which are generated/sustained by the nervous system itself, rather than any outside stimuli triggering the nervous system.

So, what is congenial insensitivity to pain and how is it caused? Congenial insensitivity to pain is primarily caused by a mutation in the SCN9A gene. This gene is responsible for the production of a substance used in nociceptors to transmit pain to the brain. Without this substance, the nociceptors are unable to function properly, and thus, unable to generate the sensation of pain. This mutation can be inherited, although the trait is recessive. Regardless, the end result of this mutation is the inability to feel physical pain. It should be noted that individuals with this condition are still able to feel touch, as well as sense changes in temperature. For instance, if a person with congenial insensitivity to pain were to spill hot coffee on themselves, they would feel the heat of the beverage. However, they wouldn’t feel the burning sensation often associated with this heat. 

Congenial insensitivity to pain frequently leads to the accumulation of injuries in the body. This is because wounds, bruises, and even broken limbs can easily go unnoticed due to the patient’s inability to sense the pain associated with them. While more severe injuries can be easily identified, even without pain, many minor injuries can go completely unnoticed without the sensation of pain. This impairs the body’s ability to heal that injury (for instance, if you twisted your leg, you wouldn’t know to stop putting pressure on it without pain), and leads to the accumulation of injuries in the body. This accumulation of injuries often results in a significantly shorter life expectancy for affected individuals, due to the numerous health issues associated with said injuries. These injuries may be especially dangerous to afflicted children, who often accumulate bite wounds on their mouth and fingers due to unchecked self-biting (this behavior is usually discouraged by pain). As children, especially infants, are unable to assess any injuries they receive, this can make the identification and treatment of various injuries especially difficult.

Thankfully, congenial insensitivity to pain is a very rare disorder. Only 20 cases have been reported in scientific literature. Still, the negative effects of such a disease demonstrate the important role pain plays in keeping our body healthy. While many of us hate the sensation of pain, that sensation helps us detect and locate any injuries in our body, which helps ensure the body can properly recover from those injuries. As terrible as it may feel, pain is a vital sensation to our body, arguably as important as touch or hearing. Without it, the body is blind to its own injuries, and any harm that is done to that body loses the opportunity to properly heal.

References:

Reeves, Alexander G, and Rand S Swenson. “DISORDERS OF THE NERVOUS SYSTEM A Primer- Chapter 19 - Pain.” Dartmouth.edu, Dartmouth Medical School, 2008, www.dartmouth.edu/~dons/part_2/chapter_19.html.

“SCN9A Gene - Genetics Home Reference.” U.S. National Library of Medicine, National Institutes of Health, www.ghr.nlm.nih.gov/gene/SCN9A

“Congenital Insensitivity to Pain - Genetics Home Reference.” U.S. National Library of Medicine, National Institutes of Health, www.ghr.nlm.nih.gov/condition/congenital-insensitivity-to-pain#resources

“Congenital Insensitivity to Pain.” Genetic and Rare Diseases Information Center, U.S. Department of Health and Human Services, www.rarediseases.info.nih.gov/diseases/12267/congenital-insensitivity-to-pain#ref_10482.

George Galanis