What is Pain?
Did you know we don’t actually see with our eyes? We see with our brain. When light hits your eye, it’s converted into electrical signals that travel into your brain and - through a complex process involving lots of guessing - your brain creates an image. This is one reason why people can see the same thing so differently (remember the great dress debate of 2015?).
How Pain is Created
Our experience of sensation is just as subjective. Just like we don’t see with our eyes, we don’t have nerves that detect pain. Instead, our nerves gather basic input about pressure, temperature, vibration, and chemical changes. These signals are sent to the brain, which determines what’s important to notice. Since the brain prioritizes survival above all else, it focuses on information that might signal a threat to our well-being.
When the brain perceives something as a potential threat, it can create the sensation of pain to prompt us to change our behavior and avoid harm. For example, stepping on a Lego might not be inherently dangerous, but your brain creates pain to prevent actual injury.
Key Points About Pain
Pain is created by the brain.
Pain reflects the brain’s opinion that something might pose a threat to your well-being.
Pain is designed to elicit a change in behavior.
Because pain is based on the brain’s perception of threat, it is inherently subjective. And this brings us to perhaps the most important point:
Pain is Real, But Not Always Accurate
Your experience of pain is real, just like every other sensation you perceive. However, since perception is subjective, pain is not always an accurate reflection of the body’s condition. This is why two people can experience the same injury so differently:
Person A’s brain might perceive the injury as a significant threat, resulting in more intense and long-lasting pain.
Person B’s brain might interpret the same injury as less threatening, leading to milder and shorter-lived pain.
This leads us to a related and very critical point:
Pain Does Not Equal Tissue Damage
Robust research shows that tissue damage and pain don’t always correlate.
It’s common to have tissue damage, such as rotator cuff tears, disc herniations, or arthritis, without experiencing pain.
Conversely, people can have significant pain without any detectable tissue damage. This is often the case with conditions like fibromyalgia or Tension Myositis Syndrome (TMS).
Even when pain does coincide with tissue damage, the intensity of pain is rarely an accurate measure of the injury’s severity. For instance, a papercut can feel disproportionately painful, while a broken bone in a cast might stop hurting long before it has fully healed.
What’s Next?
Understanding the subjective nature of pain lays the foundation for exploring related topics, such as primary versus secondary and acute versus chronic pain. Stay tuned for the next post in this series!
Have questions or need clarification? Share your thoughts in the comments below!
