"Passing out" from pain

I just saw this mentioned in a thread now going on about fainting, and it reminded me of something I’ve always been interested in.

Torturers in movies always prepare the victim by promising them all sorts of hell, and that they “will stay conscious.”

I have never been tortured, thank God, nor have I ever been in mortal agony. But in a weird way it’s always been comforting to know that the passing out could happen. The poster in that thread–please forgive me for not finding your name–says that she has fainted from pain. Why or when does this occur, and can it be “counted on”?

:smack: I checked now for who made the comment that set me off. It was by **RoniaBorkason.**Thanks.

I once fell side ways onto my ankle.

The pain was enormous and was soon accompanied by nausea and the feeling that my tongue is too big. Then I fainted - but only very briefly.

After that my ankle started to feel like it was being heated and the pain vanished for a couple of hours. Endorphins I suppose.

It depends. I think pain caused by injury may cause you to blackout, but pain caused by, say, a migraine or cluster headache can actually wake you up.

I doubt it can be counted on since I suspect (but am not sure) that such fainting is a form of “vasovagal syncope” (more appropriately called “neurocardiogenic syncope”). This is the type of fainting that tends to occur in response to some ‘shock’ to the body, (e.g. intense and sudden pain, emotional trauma, at the sight of blood, etc.) and is thus the type that presumably occurs when someone passes out from pain.

The reason I said it can’t be counted on is that only some people seem to be subject to this form of syncope (‘passing out’). For example, if you haven’t fainted by this mechanism by the time you’re a young adult, you probably never will.

(As an aside, “vasovagal syncope” is a great example of a topic where most web pages get it wrong, or at least get a lot of it wrong)

My stomach perforated in 05. I cannot imagine anything worse than what I felt. I begged god to take me home and had there been a switch that turned off the pain, but also ended my life, I would have flipped it. Not only did I not pass out, the multiple doses of morphine did not help.

I’m not saying no one passes out, but I from experience I don’t think it can be counted on.

Now there’s a coincidence - I perforated mine, too. The absolute worst pain I’ve ever had. Not for the ‘faint’ of heart :wink:

And, I never passed out from it either (although I would have paid to do so. Big bucks).

I definitely have had this happen to me. In college, I slipped on some ice, fell on my back, and passed out. The people I was with thought I had hit my head, and took me to the emergency room. Turns out I had really messed up my hip, not my head, but passed out due to the pain, and the doctor there told me it was vasovagal syncope.

Since then, I’ve experienced this when falling down stairs and badly twisting my ankle, and falling up stairs (while carrying a newborn at 3AM) and smashing me knee into a stair. In these cases, I was able to avoid passing out by immediately lying down.

I also generally get very lightheaded if I stand up to fast from a lying position.

Good to know I’d probably pass out, unless the torturers had the foresight to lay me down first. D’oh! Now I’ve told them!

For me, my stomach starts to feel very very strange (almost like I’m going to puke), and I will get tunnel vision before finally passing out.

I don’t want to highjack too much but I’ve never talked to anyone else who survived this. Did they take your stomach out too? (Technically mine is there, just not in the plumbing loop.)

Just a small part was removed. Mostly, they “oversewed” the hole, opened up the lower part of the stomach a bit (to facilitate emptying in the future) and deliberately severed the vagus nerve (since it is what gives the signal for acid release in the stomach). Now, that was a long time ago and especially with the advent of drugs like Prilosec, the surgical approach for perforation has changed.

This happened to me once. My index finger was slammed hard by a pnuematic cylinder (no damage to me), but I got quite faint, everything started turning white, and I had to sit down in a hurry, because I knew what was next: I passed out for a very few seconds.

Same thing happens every time I donate blood or they take blood from me. For this, I’m not sure it’s the sight of blood, because I cut myself from time to time, and the blood doesn’t bother me. A company doctor told me what this was called once, but I don’t remember.

While I’m not a proponent of the “everything has an evolutionary explanation” train of thought, doesn’t passing out from pain seem like something that would be strongly selected against in human evolution? I’d imagine that on the African veld, if you’re injured and immobile, you’re food.

Never passed out from pain but I can tell you, the human body makes some good pain killers when it wants to. After a very bad car wreck in the middle of the night I walked close to a quarter mile on a broken ankle with both knees cut open to the bone, one patella tendon severed. My face and head weren’t doing to well either. I sort of suspected that something was wrong because my legs didn’t work right but it was dark so I couldn’t see. I was truly surprise by my injury. I think this is what shock does to you.

I once hit the side of my mouth on a couch arm, which caused a tooth absess to break. And I did pass out.

Most commonly, vasovagal reactions–which can be to pain or a number of other stimuli–occur rather abruptly and end spontaneously after a brief (seconds to a minute or two) recovery period. It is not, therefore, a reliable way to avoid ongoing pain. It is possible to have successive vasovagal episodes, but mostly an individual will be conscious during ongoing pain such as torture, even if they are a fainter. A vasovagal reaction works by simply lowering blood pressure (lowered pulse; decreased autonomic tone in blood vessels) which lowers the perfusion pressure to the brain and causes a brief diminution in-- or complete loss of–sensorium.

Note that a vagal reaction is not the same thing as “not feeling pain” during a moment of intense distracting stress if the individual is otherwise alert. There are two other mechanisms which may come into play which can diminish pain perception.

The first is that it’s possible to overwhelm the central nervous system with so many stimuli there isn’t processing focus left for whatever is painful. It’s common during an extreme flight/fright/fight reaction for an individual to not even realize they have a serious injury until things settle down. A soldier, say, may have a foot blown off and not even realize it until he tries to run. And so on.

The second mechanism is that intense pain (and other stimuli) can release endorphins (think endogenous morphine) that masks the pain. Actually, more precisely in my experience, it masks the caring about pain. Opioid-like substances aren’t really anesthetics in the pure sense; they mask pain by making an individual care less than they otherwise would. I’ve had patients with huge loads of narcotics given for a kidney stone appear nearly unresponsive, and when you arouse them to ask if they are still in pain, the answer is “yes” once you arouse them enough to think about it…

The response to all of these mechanisms is extremely variable. In general, none of them are effective against ongoing, persistent pain, and an expert torturer is likely to be able to circumvent all natural reactions, either by providing ongoing pain, or varying the type of stimulus, or whatever.

Kidney stones.

I’d flip the switch.

That will teach you to quit getting freaky on the sofa! :smiley:

It only happened once-ish, when I was a teenager. I woke up on a Saturday morning having started my period, feeling very off. I had much stronger menstrual cramps than I understand are common (this experience is what convinced me to go on hormones for them). It was probably a combination of having recently woken up plus the pain, but I got up, went to the bathroom, held on to the wall for the 4 steps from the bathroom to my sister’s room, told my sister I felt really odd, could she go get Mom? and fell over. I came to slightly as she was dragging me back to my bed, then out again. Maybe 2 minutes out, total. Took pain medicine, was perfectly fine in an hour.

I was frightened a lot by the experience - vomiting from pain is one thing, but being gone from myself was too much, hence the hormones after that. I do have low blood pressure in general, but I have always taken steps against feeling dizzy - I wake up completely before getting up, take it slow, etc.

This was the only time that pain has made me pass out - I can get shots, give blood, have minor surgery, etc, without any problem.

Maybe… I’ve only come close when I was rock climbing (indoors) and hit my knee on a bolt. Basically, imagine if a quarter was twice its diameter, then take it, and try to jam it under your kneecap with all your might! That’s what it was like. Not a critical injury and not even the worst pain I’ve ever felt, but it was very sudden and unexpected.

IME what was happening was within the flight-or-fight response. Sudden pain caused a rush of adrenaline + sudden change of blood pressure + big intake of oxygen (when I gasped) = get ready for epic battle for survival!

Instead of the desired supercharged me, I just got all squishy and everything got all twinkly.

I passed out in Sunday school once - my friend and I were goofing around, and she hit my funny bone on the edge of the table. Bloop - passed out right under the bench. I’ve also passed out from various injuries - I’ve warned my husband about this. If I get injured, I’m going to lie down right away and you’re going to have to deal with the bleeding or whatever. I mentioned this recently - I cut my finger this week and greyed out from it (I know I’m going to pass out, so I lie down promptly). The injury doesn’t bother me, the pain doesn’t bother me, the blood doesn’t bother me - I just pass out anyway.

ETA: Forgot to say that my husband is a trained first responder, so he knows how to deal with the bleeding, etc.