Can you feel pain without being hurt? | with Tim Trevail

In this bonus episode of Let’s Talk Health, host Natalie Cook speaks with Tim Trevail to explore why pain is more about protection than damage. Together, they unpack how the brain interprets pain, why context matters, and what it really means when something hurts - from stubbing your toe to recovering from injury.

Using relatable examples, Tim explains how factors like childhood learning, fear, and even social settings influence how we feel pain. He shares how athletes train their brains to tolerate discomfort, why past injuries can trigger false alarms, and how understanding the mind–body connection can help anyone manage pain more confidently and move freely again.

Curious about how the body heals and moves? Explore your path in Health at Torrens University Australia.

Interested in helping others manage pain and improve movement? Discover Myotherapy courses at Think Education.

Connect with us and follow our news and stories:
→ Blog and Newsroom: https://www.torrens.edu.au/stories
→ TikTok: https://www.tiktok.com/@torrensuni
→ LinkedIn: https://www.linkedin.com/school/torrens-university-australia/
→ Facebook: https://www.facebook.com/TorrensUni/
→ Instagram: https://www.instagram.com/torrensuni

Transcript

Speaker: 0:09

Hello and welcome back to Let's Talk Health. In this episode, our host, Natalie Cook, talks to Tim Trevail, Director of Physical Health Programs at Torrens University Australia, about why pain isn't just about injury, it's about how our brain protects us from danger.

Tim Trevail: 0:25

I think what's important to understand there is that pain is very much individual, it's very much context dependent. So we will have what traditionally you might think is right, I bang my elbow, and that's a pain signal going up to my brain. That's an outdated way of thinking. When we bang an elbow, we activate high threshold nerve endings there and they send signals back to the brain. It's just data going back up to the brain. That's got to go via the central nervous system up to the brain. And then the brain weighs up that in the context of the environment, of what's happening there, and it produces pain. So pain is an output of the brain, it's not an input of the tissues from the body. And because there's a whole lot of this neuroprocessing in the brain, the way that we will experience pain will be very different from one person compared to another person. Let's say that you cut your finger off, right? And you are next to a hospital, you're going and you're just, you know, regular Joe, you're you're gonna experience a lot of pain with that immediately. If you are in a war zone and you're getting shot at at the same time, your priorities in the context completely changes. So I'm not really even going to be thinking about that finger that's fallen off because I've got to save myself and my friends. So there's a whole lot of processes. We call it central pain modulation. So it means that it's like a drug cabinet in your brain, and that can dampen down the signals which are coming up from whatever area's been hurt or damaged. So we've got to think of pain as a protective system. It's not a way of measuring how much damage there is in an area. Pain is about protecting us and it's about changing our behavior or modifying our behavior so we do things a little bit differently to protect us and a whole body and maintain homeostasis as a whole system.

Natalie Cook: 2:05

Okay, so the old don't touch it it hurts when you touch the hot plate technique. Perfect.

Tim Trevail: 2:10

You learn those things very young, right? You learn from a young age, and it is a learning process to figure out that protection. And that's why, as humans, we've got a very long period of being children. We've got that time to learn from our parents and those around us and build that. And that's why I said that children can sometimes have an increased experience of pain because they haven't got the context around what pain means. So I I've got a one and a four-year-old girls, and I I just um I sort of see it all the time. Like the four-year-old or even the one-year-old, they'll be running along, they'll trip up and fall flat on their face. And before they start crying, or before they sort of they've they've judged how much they should worry about that situation, they're looking up and they're looking at your parents' reaction. If you're looking very scared back to them, they're thinking, oh, I'm in danger here. The more danger I'm in, the greater sort of pain and worry I should produce. Whereas if you're a parent and you just smile and you laugh and you giggle and you say back up again, they very quickly switch and they realize they're in a safe place and then they're not needing to produce pain. So pain is a production or it's embodied, but it's also produced by our central nervous system as a way of protecting ourselves and recognizing where there's sort of actual or even perceived danger and then modifying our behavior accordingly. If we take adolescents, for example, though, they can often decrease the amount of pain because they're worried of fear about missing out. There's a whole social component around that pain. They might not want to miss out, they might develop these coping strategies where they keep trying to push through things because they're worried about a social fear or worry of missing out on things. And then with adults, we're going to see a whole spectrum of different people. Adults can perceive pain very differently. And we asked that a bit more earlier, but we know that we call this biopsychosocial contributions to pain. And really that means that pain is not just about biology, which is about the actual damage in the tissues or the inflammation around the area that can definitely influence pain, but it's also about the psychological, so how we think about pain. So, what have we been told in the past about what might contribute to pain? And then we've got the social components, and these are the context, these are the environment, these are the support networks around us. So, although some of these things aren't necessarily causative for pain, it's usually because of a result of some sort of initial perhaps damage or perceived damage to an area, all of these things will contribute and will either dial up pain if I feel safe because I've got a good network around me, or I feel safe because I understand that pain is about a potential danger. I don't think I'm broken, then that's when the central nervous system, we talked about a modulation earlier, that's when it can dampen down that pain. So we might have signals coming up from a damaged area or a sore knee, but when we're feeling safe, then we've got the context that we understand that pain is a perception rather than an actual damage, that's when we can dampen that down and we can actually feel better about it.

Natalie Cook: 4:57

It's making me think of lots of things. One is around sports people, and I'm sure they've experienced, you know, a marathon runner, I'm sure, is experiencing all sorts of pain, but yet they can push through that versus objectively, if you felt that pain, you would probably stop what you were doing. Is it a context thing? Is that what you sort of say?

Tim Trevail: 5:15

I think it's a context, but it's also an experiential thing. So athletes will, by nature of being an athlete, you've had to push your body and your systems to the edge of their ability to be able to then cause an adaptation. So you're training hard, and the goal of that training is to cause a stimulus, which will cause an adaptation in the system, so you become stronger, faster in all those sorts of things. But by doing that, you're pushing yourself to the edge of where those kind of pain might be. And if you're regularly doing that and you're realizing that yes, I could become sore, but that was part of the natural processes and I'm adapting from that, it's not my body's not actually damaged. It's just I knew the pain was a perception, but it's also just an actual kind of danger. And I know it's a protective mechanism. So if we can get anyone really to reframe pain as being a perception or a protective mechanism, so they're really aware that this is just my body trying to protect me, it's trying to maybe change my behavior for a bit, but I'm not damaged. Just because I'm getting some soreness or some pain somewhere doesn't mean I'm damaged. There's that correlation is not really that clear. And certainly there's enough of a protective barrier. Let's say I need this much activity is going to cause my muscles to break down for something to really cause damage. You've got a buffer between that level and between where your pain will start. So I'm doing this much activity, this feels fine. Okay, this is getting sore now, but you've got this buffer between where it's sore and where I'm actually causing damage. Yeah. Persistent pain, this buffer becomes bigger as a protective mechanism for an old injury. And that's when this alarm system is going wrong. So we can think of pain as an alarm system often. So it will be like the alarm might be going off at home, but sometimes it's just because you burnt the toast, other times because the house is burning down, right? Where pain is very much protective and it supports us, there's sometimes a case when it becomes maladaptive. So rather than just protecting us, it's over-protecting. And that's when we kind of go into those chronic pain spaces, and pain can last longer than it should be.

Natalie Cook: 7:08

And as you said, that sort of expectation of, oh, when I felt this before, that's when I move at my knee or something.

Tim Trevail: 7:14

And so you become hesitant to do something. How often do I hear it in clinical practice that yeah, this is an old injury from 20 years ago? Whatever the old injury was, that's healed now. The human body's amazing, amazing at adapting and amazing at healing. But the brain and the central nervous system, we have these things called neurotags that will remember what happened earlier on. So it's very much a central processing issue rather than actually because there's an injury there from 20 years ago, and it's working that out, building confidence in people that you are safe to move now and that we don't need to overly protect an area that can help the central nervous system calm down. We stop the muscle guarding that we can get around persistent pain and injury, and then people can move to higher quality of life and become more physically active again.

Natalie Cook: 7:55

And so is the inference there that it's possible to experience pain without there being any damage?

Tim Trevail: 8:00

Absolutely. So take phantom limb pain. So we we could have no leg, yet we get foot pain, for example, and we see that in those populations. So that's one way of demonstrating that we don't necessarily need a specific damage, but it's a central processing concern.

Speaker: 8:16

Thanks for listening to today's episode. To stay up to date and get more practical, evidence-based tips, hit follow or subscribe wherever you're listening. For more expert insights, search Torrens University blog on Google.

Natalie Cook: 8:29

And a disclaimer. And if you have any concerns about your health, please do consult a qualified healthcare professional.