What is stronger - the pain or the anticipation of it?

research.

How the brain creates pain: it's not that simple

So, let's start with the basics: pain is not just a physical sensation. This is a whole chain of interactions in our brain. And while physical stimulus plays a role, your brain does its part—it decideshow much pain you must be in.

Experiment

So, scientists decided to delve into this tricky game of the brain and pain and conducted an experiment that clearly answers the question: How exactly does the brain add “anticipation of pain”? to real sensations?

Participants received a visual signal that predicted pain: “mild pain” or “severe pain.” It lasted 2 seconds and looked like something like traffic light pain.
Then, after a few seconds, they a thermal stimulus was applied to the left hand. The stimulus lasted 12.5 seconds—not too long (pardon the pun).
Participants were then asked to rate their pain on a semicircular scale from 0° (no sensation) to 180° (maximum pain).

It would seem that everything is simple: if it hurts, evaluate it. But here's the thing: participants saw different visual cues before the stimulus. The cues predicted how “sick” the stimulus would be. There were three scenarios:

Low pain signal. You expect mild pain (the stimulus was associated with pain levels 1 to 4).
High pain signal. Expect severe pain (pain levels 2 to 5).
No signal. It seems like pure physiology here – no expectations, just the fact of pain.

Here's where things get interesting: Even when the stimulus was the same, participants rated the pain differently. Waiting for pain made it more intense. The brain is essentially was finishing the scriptenhancing perception.

The brain is a master of manipulation

As a result of the experiment, it became clear: our brain is a cunning manipulator. Anticipation of pain makes the pain more this. Imagine: they show you that it will hurt, and even if the stimulus is only at the “warm” level, the brain decides: “No, buddy, this is real pain!”

Here are the results in numbers.

Pain signal: β = 0.107, SEM = 0.008, z = 3.879, P = 1 × 10−4 – that is, the signal really affects perception.
Stimulus: β = 0.107, SEM = 0.005, z = 3.631, P = 3 × 10−4 – the physical stimulus is also significant, but less than the signal.
Interaction: β = 0.006, SEM = 0.003, z = 1.808, P = 0.071 – the interaction between the signal and the stimulus is on the verge, but also exists.

The brain doesn't just respond to a stimulus; it creates the perception of paincombining expectations and real physical sensations.

Limbic system

One of the key findings of this study concerns limbic system And default networks. These two parts of the brain play a role in integrating sensory information—they process pain signals and decide how much pain you should feel.

Here's what's especially interesting: when scientists analyzed the neural activity of the participants, it turned out that limbic system combines information about the signal and stimuli. That is, it not only reacts to what happens, but also adds what you expect into the equation.

The brain works as a dynamic system where every piece of information has a role, and the limbic system is like the CPU that puts everything together and creates the final product – your perception of pain.

What does this mean for us?

This experiment opens up interesting prospects for pain management. We already know that expectations can significantly influence the perception of pain, meaning there is a real potential for developing techniques that can help reduce pain sensations by changing the context and signals sent to the brain.

For example, you can organize psychological preparation before a painful procedure. Setting patient expectations in advance—showing soothing visuals or playing relaxing sounds—can significantly reduce pain perception. This preparation allows the brain to “rewrite the script” and reduce the intensity of expected pain. Perhaps in the future we will use similar approaches more often in medical practice to help people tolerate painful procedures more easily.

So what do we learn from this? The conclusion is simple: pain is not just a physical sensation. This is the result of complex processing in the brain, which turns out to take into account our expectations and anticipations. If our brains are capable of increasing pain based on expectations alone, then it may also be able to reduce pain if we learn to manage those expectations.

So the next time you are faced with something painful, ask yourself: is the pain really that bad, or is your brain playing tricks on you, setting you up for the worst-case scenario? Maybe everything is not so scary – and realizing this already makes the situation easier.