Pain is more than the state of the tissues. You feel pain when the brain decides that there is a threat to the body.
There is a tendency to think more pain means more damage and less pain means less damage. Animal and human studies show that tissue damage does not predict pain. Major injuries send louder danger signals but danger signals are not pain. Pain happens when the brain interprets these signals and decides that there is a threat to the body.
Imagine…
That the CEO (your brain) receives a report about an issue from one department. The CEO looks at all the information and asks, “Is there a threat to the company?” If the answer is yes, the CEO sends an urgent message (protection through pain) to fix the issue. If the answer is no, the CEO reassures its employees instead (does not need to protect with pain). Deciding if an issue is a threat or not depends on how the CEO interprets the situation. Like a CEO, the brain sends a pain message when it thinks the body is in danger.
What is happening in the body?
It is possible to feel pain when there is no tissue damage. Or to feel no pain when there is tissue damage. Pain is more about what the brain thinks is dangerous than it is about tissue damage. Knowing the context or meaning of your pain is important to understand why you have pain.
Suppose you step on glass, but this time, you are in the middle of a road and a bus is heading toward you. At this time, you may not feel pain in your foot. Why? Because your brain puts together all the information it has (what you see, what you hear, what you know about buses) and decides that the risk of being run over is more dangerous than damage from glass in your foot. The pain alarm does not turn on at this time. When you are safe from the bus, you may start to feel pain in your foot. This is because the brain looks at the information it has now and decides that the piece of glass in your foot is a danger that needs attention.
