How does pain travel through our body?

Pain emerges from a two-stage journey. Stage one: a 3-neuron, 2-synapse pathway — much like riding a local train, then a high-speed train, then a city metro — carries the raw signal from the body's tissues to the brain cortex. This signal carries two pieces of information: intensity and location. Stage two: the arrival at the stadium, where the signal meets thoughts (prefrontal cortex), emotions (limbic system), memories (hippocampus), and behaviors (motor cortex). This transformation turns nociception into conscious pain — an experience that is unique to each person.

Contents
  1. A reminder: our nervous system
  2. The big-game metaphor
  3. The decoding
    1. The journey: how the signal travels
    2. The game: how the signal is encoded

1 — A reminder: our nervous system

There are two nervous systems in our body:

  • The voluntary system — the one we are conscious of
  • The autonomic system — the one that operates beyond our will (heartbeat, digestion, pupil size…)

The voluntary system itself comprises two parts:

  • A motor system: which allows us to move and to react to stimuli (stepping into the shade when it's too hot, for example)
  • A sensory system: which allows us to perceive our environment in order to adapt to it

Sensory information can be neutral, pleasant (a caress, a massage), or unpleasant — and it is in this last category that we find pain, which is therefore only one part of our sensations.

2 — 🚆 The big-game metaphor

Imagine two regions, each with its own sports team. These two teams have to face each other in a championship final at The Big Stadium. Fans from both regions are going to travel by public transportation.

They leave home and take a local train to the nearest regional station. There, they board a high-speed train toward the capital city — arriving at two different main terminals, depending on which team they support. Then they take the city metro to The Big Stadium where the final will be played.

Once they have arrived, the two groups of fans are seated in a specific area of the stadium, eager for the game to begin.

The game starts and the fans vibrate with each phase of play — they laugh, they cry, they jump up and down… At the end, the winning team erupts with joy, while the losing team shows its sorrow, even its pain.

3 — 🔍 The decoding

Here we have many analogies with pain.

3.1 — The journey: how the signal travels

The journey toward The Big Stadium — 3 trains and 2 major stations — is remarkably similar to the journey of the pain signal toward the brain.

🚆 In the metaphor🧠 In the body
Local train1st neuron, from the tissue to the spinal cord (SC)
Regional station1st synapse, in the dorsal horn of the spinal cord
High-speed train2nd neuron, from the SC to the thalamus (the brain's major relay)
The two main terminals2nd synapse, at the thalamus
City metro3rd neuron, toward the sensory cortex
Fans seated by region of originNerve fibers classified by body origin (head, hands, feet…)
Number of fansIntensity of the signal
Section of the stadiumLocation of the pain
Diagram of the fans' journey: home, local train, regional station, high-speed train, main terminal, city metro, The Big Stadium
The fans' journey: home → local train → regional station → high-speed train → main terminal → city metro → The Big Stadium Illustration: douleurchronique.fr

At this point, we have a signal we call NOCICEPTION. But the game has not yet begun.

3.2 — The game: how the signal is encoded

The game starts, and this is where the nociceptive signal transforms into pain — through the entry of thoughts, emotions, and behaviors into the picture.

⚽ In the metaphor🧠 In the body
Fans laugh, cryLimbic system generates emotions
They recall past gamesHippocampus activates memories
They analyze the game phasesPrefrontal cortex builds thoughts
They raise arms, shout, jumpMotor cortex triggers behaviors
The loser (sorrow, defeat)The pain patient
The game transforms everythingNociception becomes PAIN
Illustration of fans: four joyful winners on the left, four sad losers on the right
The same end of game, two opposing experiences for the same game — the winning team erupts with joy, while the losing team shows its sorrow, even its pain. Illustration: douleurchronique.fr

Pain is thus the conscious, subjective experience that is unique to each person.