Some philosophers, such as Jeremy Bentham, Baruch Spinoza, and Descartes, have hypothesized that the feelings of pain (or suffering) and pleasure are part of a continuum.
Perception of pain
Sensory input system From a stimulus-response perspective, the perception of physical pain starts with the nociceptors, a type of physiological receptor that transmits neural signals to the brain when activated. These receptors are commonly found in the skin, membranes, deep fascias, mucosa, connective tissues of visceral organs, ligaments and articular capsules, muscles, tendons, periosteum, and arterial vessels. Once stimuli are received, the various afferent action potentials are triggered and pass along various fibers and axons of these nociceptive nerve cells into the dorsal horn of the spinal cord through the dorsal roots. A neuroanatomical review of the pain pathway, "Afferent pain pathways" by Almeida, describes various specific nociceptive pathways of the spinal cord: spinothalamic tract, spinoreticular tract, spinomesencephalic tract, spinoparabrachial tract, spinohypothalamic tract, spinocervical tract, postsynaptic pathway of the spinal column.
Neural coding and modulation Activity in many parts of the brain is associated with pain perception. Some of the known parts for the ascending pathway include the thalamus, hypothalamus, midbrain, lentiform nucleus, somatosensory cortices, insular, prefrontal, anterior and parietal cingulum.
Perception of pleasure Pleasure can be considered from many different perspectives, from physiological (such as the hedonic hotspots that are activated during the experience) to psychological (such as the study of behavioral responses towards reward). Pleasure has also often been compared to, or even defined by many neuroscientists as, a form of alleviation of pain.
Neural coding and modulation Pleasure has been studied in the systems of taste, olfaction, auditory (musical), visual (art), and sexual activity. Neural hotspots involved in the processing of pleasure include the nucleus accumbens, posterior ventral pallidum, amygdala, other cortical and subcortical regions. The prefrontal and limbic regions of the neocortex, particularly the orbitofrontal region of the prefrontal cortex, anterior cingulate cortex, and the insular cortex have all been suggested to be pleasure causing substrates in the brain.
Psychology of pain and pleasure (reward-punishment system) One approach to evaluating the relationship between pain and pleasure is to consider these two systems as a reward-punishment based system. When pleasure is perceived, one associates it with reward. When pain is perceived, one associates with punishment. Evolutionarily, this makes sense, because often, actions that result in pleasure or chemicals that induce pleasure work towards restoring homeostasis in the body. For example, when the body is hungry, the pleasure of rewarding food to one-self restores the body back to a balanced state of replenished energy. Like so, this can also be applied to pain, because the ability to perceive pain enhances both avoidance and defensive mechanisms that were, and still are, necessary for survival.
Opioid and dopamine systems in pain and pleasure The neural systems to be explored when trying to look for a neurochemical relationship between pain and pleasure are the opioid and dopamine systems. The opioid system is responsible for the actual experience of the sensation, whereas the dopamine system is responsible for the anticipation or expectation of the experience. Opioids work in the modulation of pleasure or pain relief by either blocking neurotransmitter release or by hyperpolarizing neurons by opening up a potassium channel which effectively temporarily blocks the neuron.
Pain and pleasure on a continuum
Arguments for pain and pleasure on a continuum It has been suggested as early as 4th century BC that pain and pleasure occurs on a continuum. Aristotle claims this antagonistic relationship in his Rhetoric:
"We may lay it down that Pleasure is a movement, a movement by which the soul as a whole is consciously brought into its normal state of being; and that Pain is the opposite."
Common neuroanatomy On an anatomical level, it can be shown the source for the modulation of both pain and pleasure originates from neurons in the same locations, including the amygdala, the pallidum, and the nucleus accumbens. Not only have Siri Leknes and Irene Tracey, two neuroscientists who study pain and pleasure, concluded that pain and reward processing involve many of the same regions of the brain, but also that the functional relationship lies in that pain decreases pleasure and rewards increase analgesia, which is the relief from pain.
Arguments against pain and pleasure on a continuum
Asymmetry between pain and pleasure Thomas Szasz notes that although we often refer to pain and pleasure as opposites in such a way, that this is incorrect; we have receptors for pain, but none in the same way for pleasure; and so it makes sense to ask "where is the pain?" but not "where is the pleasure?". With this vantage point established, the author delves into the topics of metaphorical pain and of legitimacy, of power relations, and of communications, and of myriad others.
Evolutionary hypotheses for the relationship between pain and pleasure South African neuroscientists presented evidence that there was a physiological link on a continuum between pain and pleasure in 1980. First, the neuroscientists, Mark Gillman and Fred Lichtigfeld demonstrated that there were two endogenous endorphin systems, one pain producing and the other pain relieving. A short time later they showed that these two systems might also be involved in addiction, which is initially pursued, presumably for the pleasure generating or pain relieving actions of the addictive substance. Soon after they provided evidence that the endorphins system was involved in sexual pleasure.
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