Pain has been thought of as the amount of damage to tissue = amount of pain felt, but in recent years this has been shown to be incorrect as people in war time situations may not feel pain even though they are missing a limb. How can this happen?
Pain processing occurs within the central nervous system and is an emotional and physiological process with no individual experiencing the same type of pain from the same type of injury. Structurally the noxious stimuli is processed within the thalamus and is combined with past experiences and emotional experiences to create the pain experience. The response to nociception is created within the somatosensory cortex, cingulatae gyrus and the insular cortex (Treede & Apkarian, 2008). If your brain does not feel like the information from your tissues is not worth listening too – i.e. if you are a soldier who’s in a life and death situation – it won’t listen to it until there is no danger or other experiences that are of greater importance.
These parts of the brain can determine whether the noxious stimuli is worth listening too depending on the threat level determined (Butler & Moseley, 2003). If no threat is perceived by the brain then minimal focus will be placed on the injury or damage and therefore the pain experienced. But if an input has a past experience associated, and the brain perceives negative consequences if it is not addressed, the signal will receive greater attention and therefore the output is greater. Below is a schematic representation of the pain profile.

Pain schematic

For example if you have had a bad ankle sprain in the past and it took you a long time to heal, you were out of sport for a long period of time and it had impacts on your work, activities and social life, if you sprain your ankle again these memories will return and cause you to be more protective of your injury as your brain will perceive the injury to have a greater impact on your wellbeing. The only difference this time is you didn’t actually do any damage to your ankle – your brain and past experience just thinks you did.
Pain is a complex thing and new information is coming out all the time – but the biggest thing to remember is that the pain experience is independent of the amount of tissue damage and your brain and through processes actually have a huge impact on what you feel.

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Butler, D. S., & Moseley, G. L. (2003). Explain Pain. Adelaide: Noigroup publications.

Treede, R. D., & Apkarian, A. V. (2008). Nociceptive processing in the cerebral cortex. The senses: a comprehensive reference, 5, 669-697.

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