By the age of 25, I had 10 nieces and nephews. As a babysitter and playmate, I have had the pleasure of watching these wonderful children grow up. At times, I have also had the responsibility of keeping them safe. And as any parent, or surrogate guardian knows, they will try almost anything. They are exploring their world—as they should!—but sometimes this seemingly reckless behavior is frightening. Take one serving of endless imagination, a splash of curiosity, and two servings of very little fear, and what do you have? A constant reminder that you need to clone yourself 10 times over to even begin to keep up. After all, they don’t fully understand danger and its consequences.
The good news: most parents have biology on their side, a built-in warning system. Take this classic example: If a child touches a hot stove, he or she will most likely only do it once!
But what if the inability to feel pain was added to the childhood recipe? At first glance, this may seem like a blessing. Who wouldn’t want their child to go through life without having to experience pain? But the inability to feel pain, known as Congenital Insensitivity to Pain (or CIP), is no blessing. In fact, it’s a disaster waiting to happen. Pain and other sensory signals serve as nature’s red flags to children and adults alike, alerting us that “This is dangerous!”
In the absence of this warning system, children with this disorder often bite through their tongues and break bones without shedding any tears. They carry on playing with their friends and, without any attention to their wounds, their injuries only worsen. Many times, it usually takes a limp or copious amount of blood for a parent or teacher to notice. Many wear goggles to avoid injuring their eyes with their fingers. Some parents teach their children to say “ouch” every time they feel a bump of any kind. And because there is no cure, caution is paramount when raising these children. Although they are completely oblivious to any pain sensations, many still feel pressure, touch, and even hot and cold.
Neurologists have found the majority of CIP children to have otherwise normal physical exams. However, upon closer inspection, some abnormalities begin to tell the full story behind what makes these children so unique. Genetic testing has revealed that this disorder is caused by mutations that must be inherited from both parents. In some patients, as a result of these mutations, an important message-carrying nerve is missing in the spinal cord. Therefore, pain signals are never perceived by the brain. Think of this oversimplified analogy: The pain signal is like a metro train and Times Square is the brain. Research shows that some CIP individuals have no tracks (nerves) for the train (signal) to run on and, therefore, the train never makes it to its stop; just like the pain signal never makes it to the brain.
As adults, these individuals are wiser and more careful about their environment. Nevertheless, most suffer from the long-term effects of childhood injuries (and we are not talking about your average playground tumbles). A significant amount of adults with CIP lost eyes and fingers as children.
CIP reminds us that an appropriate amount of pain and fear play a necessary role in our lives. So next time your child gets a boo-boo, don’t get too discouraged. It may teach him or her an important lesson, a blessing in disguise.
For more information, or to watch some interesting stories on this topic, check out the documentary, A Life Without Pain.
Congenital Insensitivity to Pain
Praveen Kumar B, Sudhakar S, Prabhat MPV
Department of Oral Medicine & Radiology, St. Joseph Dental College, Duggirala, Eluru (Andhra Pradesh) – 534003, India.
Online Journal of Health & Allied Sciences Vol. 9, Issue 4: Oct-Dec, 2010
Congenital insensitivity to pain: an update
Elna M Nagasakoa, Anne Louise Oaklanderb, Robert H Dworkin
Pain. Volume 101, Issue 3, February 2003, Pages 213–219