from Hacker News

A built-in 'off switch' to stop persistent pain

by gmays on 10/9/25, 8:27 PM with 108 comments

• by delichon on 10/9/25, 9:23 PM

  I'd like to give an off switch for pain to every adult. Here you go, just turn it off if you need to. But if someone gave one to me I'd be in trouble, if not dead. When my back pain got severe I may well have killed the messenger, ignored the pain, and not have made the lifestyle changes that eventually gave me relief by fixing the problem. People with congenital insensitivity to pain usually have multiple damaged joints by adolescence. It's not very enviable.

• by Paracompact on 10/9/25, 9:27 PM

  > The drive to look deeper into these neurons grew out of a simple observation Betley and his team made shortly after he joined Penn in 2015—hunger could dampen long-term pain responses. “When it came to chronic, lingering pain, hunger seemed to be more powerful than Advil at reducing pain.”

  This in itself is a very interesting observation. I've always been inclined to fast during times of pain and anxiety, and honestly it kind of works? Could well be part of meditative fasting's popularity throughout history.

• by EA-3167 on 10/9/25, 9:03 PM

  Anyone who's experienced or knows someone who has experienced chronic pain appreciates how desperately the world needs a major breakthrough in this arena. Pain management has evolved, there are steady improvements, but unfortunately a lot of people are effectively left behind and the choice becomes a series of profoundly mind-altering drugs... or profoundly mind-altering pain. The way that pain can erode your personality and your life is hard to express quickly in words, but it's both invisible and endlessly corrosive.

  I certainly hope that this or another path of research leads to a new generation of therapies that don't depend on opioids and are more effective than current alternatives.

• by alinajaf on 10/10/25, 4:04 AM

  Many of the comments here talk about lifestyle changes, and I think those are key, but there are some, (perhaps rarer) conditions that unfortunately won't be improved.

  Trigeminal Neuralgia is one of them. The condition is just... pain. Lot's of pain. More pain than anyone should ever have to go through. When I have episodes, I often feel awe that it's even possible for someone to feel such an incredible amount of pain.

  Challenges in life help to shape you, make you who you are. But I do feel that this particular challenge was one where it would have been nice to have learned the same lessons some other way. I hope sincerely that treatment based on this research can help.

• by pedalpete on 10/9/25, 9:33 PM

  This is very interesting, and I think points to the psychosomatic elements of pain, which is probably usually dismissed as "it's all in your head". But really, all pain is "in our head", it just tells us that the pain is elsewhere.

  The bigger opportunity here may be not to dismiss pain as being in the head, but recognizing that when it is, treating the suspected source is not the best route, or maybe not in isolation.

• by monster_truck on 10/10/25, 4:56 AM

  I've had cluster headaches my whole life. As a kid I would describe them as "a 40 foot tall giant hammering an ice pick through my skull into my eyeball". Tried a lot for a long time, nothing worked. Sometimes standing in the hottest shower possible until I inexplicably throw up and then feel perfectly fine works, sometimes it doesn't.

  There's really no understating the pain, it is not "2 dimensional", which is what I would use to describe every other form of pain I have experienced. It has a shape with immense depth and detail.

  Then I got a pretty severe concussion and I mentioned to my doctor at one of the checkups months afterwards that I haven't had any since, they casually threw out "it's entirely possible you're still experiencing them and you just can't feel them now". Scared the hell out of me, but what're you gonna do? They did eventually come back. If we figure it out in my lifetime I'll be damn impressed.

  All that said, I wouldn't want to turn pain off. It's important to learn to live with and through it, whatever the source might be, if it cannot be fixed.

• by mhb on 10/9/25, 9:15 PM

  "The current work started when Nitsan Goldstein, who was a graduate student in Betley’s lab at the time, found that other urgent survival needs such as thirst and fear can also reduce enduring pain. That finding supported behavioral models developed in collaboration with the Kennedy lab at Scripps, suggest filtering of sensory input at the parabrachial nucleus can block out long-lasting pain when other more acute needs exist.

  “That told us the brain must have a built-in way of prioritizing urgent survival needs over pain, and we wanted to find the neurons responsible for that switch,” says Goldstein."

• by olly994 on 10/10/25, 8:08 AM

  With impinged nerves in my neck, arm and rear delt, limited (painful) spinal movement so bad I struggled to walk from one part of the house to the other.

  My (painful) solution was to get a chiropractor to force movement into my spine and other areas. Pain level 11-10. Slowly thing changed but not enough for my satisfaction. Today I play 2 hours of badminton once a week, train with weights every day and do Dragon Flags to few days a week, go out into the mountains twice a week. Now I'm almost totally pain free and at 67 I can't expect perfection but you never know. By the way this is all done with no medication or painkillers.

• by OptionOfT on 10/10/25, 2:23 AM

  I recently got a new hip (at the old age of 36).

  Due to said age it was VERY hard to find a doctor willing to replace my hip, EVEN THOUGH I had 2 failed repairs, and had to resort to opioids to sleep.

  And long-term opioid usage (not abuse!) can cause higher the risk of persistent pain after a total hip arthroplasty.

  Thankfully this is not the case for me. But it was a big concern in this journey.

• by zackmorris on 10/10/25, 4:42 PM

  This reminds me of an article that I saw 10-20 years ago about delivering small amounts of morphine or another opioid to the spine to stop the transmission of pain as effectively as administering medication to the whole body, using an intrathecal pump:

  https://en.wikipedia.org/wiki/Intrathecal_pump

  Supposedly there are few or no side effects since the dose is small and localized. Kind of a shame that it's not more broadly known or used IMHO, since I've been close with people with chronic pain whose quality of life was greatly impacted.

• by instagib on 10/10/25, 6:14 AM

  It makes me think some of these special breathing exercises can reduce pain for a bit similar to meditation. Include exercise. Fasting as mentioned but it can aggravate other symptoms. Fear inducing scenarios usually reduce pain but it’s short lived. Searching for fear sounds like a terrible idea to calm chronic pain.

  I keep coming back to cervical disc issues that don’t heal and continue to worsen. Exercise like jogging can worsen things. Lifting, pt stretching, walking, and no improvements.

  I could take a pill but it wouldn’t let me know my limits and I would definitely overextend myself then probably make things worse at a faster pace.

  [This research also suggests that behavioral interventions such as exercise, meditation, and cognitive behavioral therapy may influence how these brain circuits fire, just as hunger and fear did in the lab.

  “We’ve shown that this circuit is flexible, it can be dialed up or down,” he says. “So, the future isn’t just about designing a pill. It’s also about asking how behavior, training, and lifestyle can change the way these neurons encode pain.”]

• by mmaunder on 10/10/25, 3:54 AM

  Very interesting. I’ve been battling a herniated disk. It’s the most pain I’ve ever been in. Debilitating. Stuart McGill’s “Back Mechanic” is an illuminating read. The “big 3” exercises have become my staple and they seem to mask the pain long before the underlying injury heals, which takes about a year. So the ideas in this article resonate with me. In particular pain itself becoming self perpetuating, and mechanisms to block pain like hunger. My issue is temporary, but it’s introduced me to the reality that some have been handed a lifetime of non negotiable pain. So this is important work.

• by ElijahLynn on 10/9/25, 9:25 PM

  Pain Brain Film (dot com)

  "A documentary that follows the largest fMRI randomized controlled trial challenging conventional wisdom about chronic pain, and revolutionizing treatment for millions."

  Explains how these neurons get wired to fire when there is no physical stimulus causing the pain. Similar to phantom limb syndrome.

  There's a book called The Way Out, which documents the technique used in the study featured in the Pain Brain Film above.

  I can fully attest to this technique. It 100% works. I had chronic neck and back pain for 20 years. I thought it was my desk, I thought it was my posture, thought it was my chair. Nope, it was my mind.

• by mikrotikker on 10/11/25, 1:34 AM

  My wife has chronic pain from Endo, even after hysterectomy. We think it's in the lining of the abdomen now and the pain looks intense. Cannabis being one of the only things that can take the edge off. I think that many women suffer with this condition but due to the lack of research into it there isn't really anything doctors can do for her, or prescribe her (they've tried many drugs).

• by unixhero on 10/10/25, 3:20 AM

  Impinged ahoulder and other shoulder pains

  ---

  I have another. Hanging (dead hang) from a pullup bar or staircase. It fixes it. 30 seconds every day, or 3 sets of 30 seconds

• by solomonb on 10/9/25, 10:20 PM

  I would be hesitant to turn off some physical pain like that of an injury I don't want to overextend, but for something like a chronic headache this would be a godsend.

  My most effective treatment for headaches is imitrex but you have to time it correctly and I really hate how it makes my body feel.

• by cluckindan on 10/9/25, 9:29 PM

  The question is whether the fire is truly out, or whether the chronic pain is a product of socioeconomics.