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“Pain is always real.”
That’s one of the most important things we can understand—and remember—about pain. Even if there’s no visible injury, even if scans or tests don’t show a clear problem, the experience of pain is real, and it matters.
The International Association for the Study of Pain (IASP) updated their definition of pain to:
“An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
At first glance, that might sound like medical jargon—but there’s a lot of meaning packed into that sentence. Let’s break it down and explore what this actually tells us about how pain works.
Pain Is More Than Just a Physical Sensation
When most people think of pain, they think of physical injuries: cuts, burns, sprains, or bruises. But pain can also be associated with both sensation, and emotion. That means our feelings, expectations, and even stress levels can influence how much pain we feel—or whether we feel it at all.
- Sensation might come from a stubbed toe, a hot surface, or a twisted ankle.
- Emotional influence might come from worry, fear, or even the anticipation of pain. Another word for sensation is perception .
Consider two people with similar physical injuries—but one sustained theirs during combat. Veterans often report higher pain levels, likely influenced by the psychological impact of trauma. Post-traumatic stress disorder (PTSD), which is more severe and complex than typical stress responses, can heighten pain perception and complicate recovery.
Pain Can Happen Without Injury
Yes, really.
Pain doesn’t only happen when there’s actual tissue damage. It may also be triggered by the threat or potential injury. Our nervous are constantly interpreting signals from the body and making decisions about how to protect us. Sometimes, that means generating pain to make us stop or move—even when there’s no injury.
For example, imagine touching a hot stove. You might jerk your hand away before you actually get burned. That uncomfortable sensation may be your nervous system protecting you.
Why would watching a scary movie become uncomfortable?
Why would watching someone get hit in the groin result in an unpleasant sensation?
A Snakebite Story That Teaches Us About Pain
In his book Painful Yarns, pain scientist Lorimer Moseley shares a powerful story from his own life. While hiking, he felt a scratch on his leg—nothing unusual. But it turned out to be a bite from one of the most venomous snakes in the world. He was rushed to the hospital and thankfully survived.
Later, while hiking again, he felt a similar scratch. This time, he dropped to the ground in intense pain—only to discover it was just a twig.
Why did the same sensation cause such a different response?
His nervous system was alarmed by the first event and went into high alert, triggering severe pain to protect him—even though there was no real danger the second time. This is called sensitization, where the nervous system becomes more sensitive after an injury or trauma. This is similar to a bruise that is very painful to light touch even tough touching the bruise will not cause more injury.
Pain Is a Sensation and a Perception—And the Brain Plays a Big Role
This story highlights a key point: pain is not just something we feel in our body—it’s something we interpret with our nervous system.
Think about tickling a child. After a while, even moving your fingers toward them can make them squirm and giggle. They’re responding not to the touch, but to the expectation and perception of getting tickled.
Pain can work the same way. Have you heard someone say “that looked like it hurt” or have you experienced discomfort watching someone get a shot at the doctors office or felt a tingle in your knees while watching someone fall.
Over time, our nervous system can become more sensitive to certain signals. This helps explain why chronic pain often continues even after the original injury has healed.
Healing Requires More Than Physical Treatment
Pain involves the brain, spinal cord, and nerves—not just bones, joints, and muscles. Yet many treatments still focus only on the physical side. To really help people in pain, we also need to consider the neurological and emotional factors.
That’s where pain education, movement-based therapy, and hands-on techniques like manual therapy come in. These approaches aim to affect the nervous system, reduce sensitivity, and restore function.
The Bottom Line
Pain is real. It’s personal. And it’s more complex than we often think.
Understanding how pain works—how it’s influenced by our brain, emotions, past experiences, and environment—can be a powerful first step in managing it more effectively. As pain science continues to evolve, our job is to keep learning and applying that knowledge to help ourselves and others live better.
If you’re dealing with persistent pain, don’t lose hope. The more you understand it, the more control you can regain.
References:
International Association for the Study of Pain. IASP Taxonomy. http://www.iasp-pain.org/Education/Content.aspx?ItemNumber= 1698[/embed]. Accessed May 27, 2014.
Moseley GL. Painful Yarns: Stories and Metaphors to Help Understand the Biology of Pain. Canberra, Australia Dancing Giraffe Press; 2007
Global Health & Wellness Institute 
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