When It’s Hard to Breathe, Maybe Pain Doesn’t Matter

Dyspnea (shortness of breath) and pain are well-evolved warnings of important physiological derangements that may require animals to alter their behavior to survive. Dyspnea and pain are also two of the most common symptoms that bring patients to medical care, another potentially adaptive behavior. Chronic dyspnea and pain, however, cause suffering and disability in many millions of patients; they often occur together in individuals. Although there has been great progress in recent decades in understanding the neurophysiology of pain, less is known about the neurophysiology of dyspnea, and even less is known about the interaction of these two symptoms. In the current issue of the Journal, Morelot-Panzini and co-workers present a novel and interesting study showing that the presence of experimentally-induced dyspnea inhibits a pain reflex. The results provoke us to think about both the commonality of pain and dyspnea pathways, and about how they may interact. Page 2 of 4