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Understanding Pain: How does pain work?

Updated: Jun 12, 2023

Pain is the body’s alarm system. When something happens to the body, for example, someone steps on a pebble while walking barefoot, the nerves in their foot are triggered to send a signal to their brain that says, “something’s going on down here”. This tells their brain to make them look down to see what’s happening to the foot. If they look down, see that they stepped on a pebble, and the foot looks just fine, their brain then sends a signal back down to the nerves in the foot to tell them they can calm back down, because nothing major is happening.

The nervous system

What if instead of stepping on a pebble, the person stepped on a nail?

The first part of the process would be the same: the nerves in the person’s foot would send a signal up to their brain, saying “something’s going on down here”- but when the person looked down to see what was happening to their foot, and noticed a nail sticking out, their brain would send different signals back down to the foot. This time, the brain would decide that the foot needed to be protected from further damage, and it would trigger pain, swelling and sensitivity in the foot so the person would stop walking around on it and let it heal.

If all went well, and the foot healed nicely, the pain, swelling and sensitivity would all slowly go back to normal as the cut healed, the brain saw that everything was healing nicely, and it decided that the foot didn’t need to be protected anymore.

Unfortunately, sometimes the body’s pain system doesn’t go back to behaving normally after an injury has healed. Sometimes things like pain, swelling and sensitivity linger in the body long after an injury has healed. If this goes on for more than a few months, the body’s pain system can begin to change, making the pain worse and worse over time. This often what happens when chronic pain develops.

People with chronic pain know that something’s wrong. They know the pain they’re having is not normal. Unfortunately, many of them have the experience of having test after test (MRI’s, x-rays, etc.) tell them nothing’s wrong. The problem is that the tests aren’t testing the body’s pain system. We don’t yet have a test that can detect the changes in nervous, immune and endocrine function that happen when chronic pain develops.

The good news is that by understanding how chronic pain develops, and why it’s happening, people can address the root of the problem – a faulty internal alarm system – and gradually get their pain systems working more and more normally, producing less and less pain.

People with chronic pain often find it helpful to focus on treating their pain system as a whole rather than focusing just on the area of their body that was originally injured or painful. Many different therapies and lifestyle changes can help. People with chronic pain often try treatment after treatment, without anything taking their pain away – but by taking a different approach, and combining a bunch of pain management strategies that each help a little bit into a holistic daily pain management routine, many people find that their pain can be gradually reduced, as if someone were turning down the volume on their pain rather than flipping an on-off switch.

If pain is a problem in your life, consider chatting with your preferred healthcare provider about changes you can make to your daily life and your pain management routine that can help you gradually reduce your pain and get your life back. For more information about where to start, check out Pain U Online ( or painHEALTH (

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