Anatomy of pain

We know from research that pain arises only when certain regions in our brain are activated i.e. when we suffer an injury the nervous system sends a signal to our brain. Only after this signal has reached particular areas in our brain, can we feel the pain.

Pain always consists of three components:

  • sensorial (bodily sensations)
  • affective (agitation)
  • cognitive (thoughts).

During a phase of pain, for each of these three areas a different region in our brain is activated.

Sensorial aspect of pain

The sensorial component is the perception of the mere sensation in that part of the body that has been injured. The sensation can present itself for example as a burning, piercing or stabbing feeling.

Affective aspect of pain

How we react to pain as well as how we perceive pain play a central role. Usually pain causes an unpleasant emotional state. But vice versa, emotions also have a certain effect. Pain – unless it is chronic – has the function of warning us. Thus strong emotions can make us perceive pain more intensely and severely than usual. For example a backache has a different meaning to someone suffering from cancer than to a pregnant woman who is looking forward to the birth of her child. To people suffering from a severe disease, pain means a significant danger and a potential threat to their health and their future. This, in turn, can influence how intensely they perceive the pain.

Cognitive aspect of pain

Thoughts which are related to pain also influence the degree to which we perceive pain. It makes a difference if our sensation of pain is accompanied by the thought: “If things continue like this, I will lose my job” or with the thought: “I should slow down a little today”.

While the sensorial part of pain can be attributed to the somatic domain, the affective and cognitive part is related to psychological processes. However, these three components are always present and have a mutual influence on each other. This means that even though pain is perceived at the sensorial level, the intensity of pain is also determined by affective and cognitive factors.