What Hurts and What Doesn’t

How the body responds to pain

Photo: Mitchell Hollander/Unsplash

I’ve been thinking about pain lately.

Last week, a teenage friend fell and broke her wrist while snowboarding. The accident itself was reportedly low on the drama scale, yet the ensuing pain sidelined her. When ski patrol arrived on the scene to zoom her to safety, they administered fentanyl in response to her insistence that the pain level was a 10.

As her story bounced from friend to friend (my children among them), kids responded with condolences and reflections on their own adventures and mishaps that yielded broken bones. Testimonies flew via Snapchat. “I was in shock, but didn’t cry when I broke my ankle.” “When my arm broke, it hurt so much I thought I was going to throw up.” “I broke my shoulder, but weirdly it didn’t bother me that much.”

Struck by the variation in experience bouncing past me via recycled stories, I wondered about the x-factor in how badly each break felt. Was the severity of the accident the cause? A diversity of pain thresholds?

As Nir Eyal writes, there is some pretty fascinating psychology at work when it comes to why pain sometimes derails us and sometimes feels wholly manageable. “It is possible for the body to be harmed and for the brain not to generate pain, and, equally, for the body to be safe but for the brain to launch into agonizing panic mode because it has misinterpreted some stimuli as an attack.”

Does that mean that how our brain interprets injury or discomfort has far more impact on the pain we feel than the degree of injury or discomfort itself? New research on chronic pain leans toward yes. Advances in pain management (including the use of virtual reality and hypnosis in lieu of narcotics and anesthesia) signal something similar.

And though, as Eyal acknowledges, that isn’t to dismiss pain as something we imagine, there is real promise in the idea that we might learn ways to minimize the intensity of a painful experience.

Senior Platform Editor, Elemental. I write and edit stories about health, science, well-being, and behavior.

Sign up for Inside Your Head 🧠

By Elemental

A weekly newsletter exploring why your brain makes you think, feel, and act the way you do, by Elemental senior writer Dana Smith. Take a look.

By signing up, you will create a Medium account if you don’t already have one. Review our Privacy Policy for more information about our privacy practices.

Check your inbox
Medium sent you an email at to complete your subscription.

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store