Understanding Pain: A Tale of Two Nails

Pain is part of the human experience that is a very important warning signal – an alarm, if you will. It’s our body’s way of telling us something might be wrong. It turns out that this alarm is sensitive to many signals the brain receives, but also not very specific about what the alarm means. As pain scientist and physician, Dr. Howard Schubiner states: “ALL pain is created in the brain.” That doesn’t mean it’s not real – it’s very real. It is the brain’s interpretation of the signals it receives. So, the pain someone feels is never created in the body’s tissues. It’s exactly like how what we see visually is not created in the eyes, but is created and interpreted by our brains. And just like our vision can be deceived with optical illusions, so can our interpretation of pain. 

Let’s discuss a couple of amazing examples on opposite ends of the pain spectrum: What if pain can happen even when there’s no injury—and sometimes, no pain even when there is? These real-life examples show how pain is created in the brain, and how our thoughts, emotions, and past experiences can shape what we feel.

No Pain, Big Problem 

A construction worker named Patrick Lawler was using a nail gun on the job. At one point, he felt a small bump on his face but didn’t think much of it. Days later, prompted by a headache and blurry vision, he decided to seek medical help. When he went to the hospital, doctors found a 3.25-inch nail lodged in his brain. He had accidentally shot himself in the head—but felt no pain at the time.

How is that possible? Dr. Howard Schubiner explains: “Pain doesn’t come from the body part where it’s felt—it’s created by our brain, signaling that something needs attention.” In Patrick’s case, his brain didn’t recognize the injury as dangerous right away. So it didn’t send pain signals. This shows that pain isn’t just about damage—it’s about how the brain interprets what’s happening. 

Big Pain, No Problem

Now let’s look at another story. A famous story in medical research talks about a man who stepped on a nail that went through his construction boot. When he saw it happen, he was in immediate excruciating pain and was rushed to the hospital screaming the whole way. But when doctors took off his boot, they found the nail had gone between his toes. It hadn’t touched his skin at all. 

So why did he feel so much pain? 

His brain saw the nail and assumed danger. That fear triggered a full pain response—even though there was no injury. Let’s be clear: it was REAL pain, not “all in his head”. His brain reacted to the visual stimulus of danger and turned that alarm bell way up.

As Dr. Schubiner says: “Pain is a danger signal, not a damage signal. It’s the brain’s way of saying something might be wrong.”

This story shows how expectation and emotion can create pain, even when the body is fine.

So, What Is Chronic Pain? 

Chronic pain is pain that lasts longer than expected—usually more than three months. It can happen after an injury, or even when there’s no clear cause. People with chronic pain often feel stuck. They’ve tried treatments, but nothing seems to help.

That’s because chronic pain is often neuroplastic. This means the pain is coming from the brain’s pain pathways—not from damage in the body – even after an injury has occurred and perhaps long healed.

Dr. Schubiner explains: “Your brain has created a neural pathway that remembers the pain and keeps you trapped in a vicious cycle. Your brain fears the pain, that causes you stress, and the stress makes the pain real.” In chronic pain, the brain keeps sending danger signals—even when the body has healed. These signals are shaped by memories, emotions, and stress.

How Emotions Affect Pain

Our emotions play a big role in how our brains feel pain. Stress, anxiety, sadness, and fear can all make pain worse. “Our emotions and stress activate the same pain centres in our brain as an injury,” says Dr. Schubiner. Think about a time you felt nervous and got a stomachache. Or when you were sad and felt heavy in your chest. That’s your brain turning emotional pain into physical pain. In chronic pain, this connection becomes stronger. The brain learns to expect pain—and that expectation can make the pain real.

Pain Memories: Why Pain Keeps Coming Back

Pain memories are like habits in the brain. If you’ve had pain for a long time, your brain gets used to sending pain signals. Even small triggers—like movement, stress, or certain thoughts—can activate those pathways. 

It’s like a well-worn path in the forest. The more you walk it, the deeper it gets. But here’s the good news: you can build a new path. That’s where neuroplasticity comes in. We can teach your brain to respond differently to pain signals.  

You learn to see pain as a false alarm—and calm the fear that keeps it going. You can change emotional patterns that may be linked to your pain. You can learn to take that progress and turn the alarm bells back down again.

What You Can Do Today If you’re living with chronic pain, here are some steps you can take:

• Learn about pain: Understanding how pain works can reduce fear, change your brain’s reactions, and help you heal.
• Notice your emotions: Stress and sadness can make pain worse. Be kind to yourself.
• Move gently: Safe movement helps your brain feel less threatened.
• Talk to someone: You don’t have to do this alone. Reach out to an empathetic practitioner for help.

Final Thoughts: Pain Is Real—And Changeable

The stories of the two nails show us something powerful. Pain isn’t just about injury. It’s about how the brain sees danger. Sometimes, the brain gets it wrong. But with the right tools, you can teach it a new way.