Dr Kelly Wade/Cosmos Studios in partnership with SAHMRI
Discover the mechanisms behind different types of pain, including chronic and neuropathic pain, and how spider venom and VR are leading the way toward breakthrough treatments.
You stub your toe on the corner of the coffee table. A second later, pain flares. It’s sharp, it’s urgent — and then, strangely, it fades. Why did it hurt in the first place? Why did it stop? And why does that same body, in another moment, let a headache or stomach ache linger for days?
Physical pain is something almost every person feels, but few of us truly understand. For centuries, it was seen as a simple signal from body to brain. But modern science is revealing a far more complex story. Pain doesn’t just warn us when we’re injured. It can persist long after the body has healed. Sometimes, it arises even when nothing’s physically wrong.
So what exactly is pain? And how is science — including groundbreaking research right here in Australia — helping us understand, measure and manage it?
The most common type of physical pain acts like the body’s built-in alarm system. Credit: Getty images.
What is pain, and why do we feel it?
The most common type of physical pain is often described as the body’s alarm system — an urgent signal that something is wrong. When you touch a hot stove or twist your ankle, specialised nerve endings called nociceptors detect the damage or potential danger. These sensors send electrical signals through your spinal cord and into your brain.
But it’s not until the brain interprets those signals that pain becomes real. That’s what makes pain both a physical process and a personal experience. It’s shaped not just by what happens in the body, but by how the brain reacts — factoring in memory, mood, context, and even expectation. Some people are even born with rare genetic conditions that prevent them from feeling physical pain at all. These people typically suffer frequent injuries, burns, or broken bones without realising it. Some die young because their bodies can’t warn them when something’s wrong. It’s a powerful reminder that pain, while unpleasant, is essential for survival.
In evolutionary terms, pain teaches us to withdraw from danger, to rest and heal. Credit: Getty images.
Types of pain: Understanding the many faces of pain
In evolutionary terms, pain is protective. It teaches us to withdraw from danger, to rest and heal, and to avoid behaviours that could harm us again. But sometimes the system goes wrong. The body continues to send pain signals even after tissues have healed. Or the brain keeps interpreting normal signals as dangerous. That’s when pain becomes a problem in itself — not just a symptom, but a condition.
Pain isn’t a one-size-fits-all sensation. Scientists classify it into different types based on where it starts, how it works, and how long it lasts. Understanding these categories helps medical practitioners diagnose conditions and tailor treatments. It also helps researchers develop new medicines and other treatments tools.
Acute pain
This is the type of pain most of us know well. It’s sharp, short-lived and often linked to a clear cause — like the pain you get when you fall over or get a paper cut. Acute pain acts like an emergency siren, warning us to stop, rest, or protect the injured area. It usually fades as the body heals.
Chronic pain
Chronic pain lasts longer than three months and can persist even after the original injury has healed. It’s often invisible, unpredictable, and deeply disruptive, affecting sleep, mood, memory, and movement.
Examples of chronic pain include chronic back pain, arthritis, irritable bowel syndrome (IBS), and chronic migraines. Some people live with chronic pain for years or decades, and its causes are sometimes difficult to pinpoint.
Pain isn’t one-size-fits-all. Scientists classify it into different types based on where it starts, how it works, and how long it lasts. Credit: Getty images.
Neuropathic pain
Neuropathic pain comes from damaged or malfunctioning nerves. It’s often described as burning, shooting, or electric. Conditions like shingles, diabetes, phantom limb pain, and some spinal injuries can trigger neuropathic pain. Because it originates in the nervous system, it doesn’t always respond to typical painkillers.
Neuropathic pain can be acute or chronic, but many long-term pain conditions fall into this category.
Nociplastic pain
This newer category describes pain that isn’t caused by tissue damage or nerve injury, but by the way the nervous system processes signals. It’s as if the brain’s ‘volume knob’ for pain is turned up too high. Conditions like fibromyalgia, irritable bowel syndrome, and some cases of endometriosis fall into this group. All nociplastic pain is chronic.
Nociceptive pain
Nociceptive pain is caused by actual or potential damage to body tissues. It’s detected by nociceptive pain receptors — those specialised nerve endings that sense heat, pressure, or injury. Most (though by no means all) acute pain is nociceptive. Doctors usually divide nociceptive pain into two subtypes:
Visceral pain
This pain comes from the body’s internal organs — like the stomach, intestines, or bladder. It tends to feel dull, crampy, or hard to pinpoint. Conditions like appendicitis, IBS, or period pain are common causes.
Somatic pain
Somatic pain comes from the body’s musculoskeletal system: the skin, muscles, bones, or joints. It’s usually easier to locate and describe — think of the sting of a scraped knee or the deep ache of a broken bone.
Together, these categories help explain why pain can feel so different from one person to the next — and why one treatment doesn’t work for everyone.
Diagnosing pain can be complex, often relying on detailed descriptions and history rather than scans, and may require a team approach for effective treatment. Credit: Getty images.
How do you know what kind of pain you have?
Diagnosing pain isn’t always straightforward. Doctors don’t just ask where it hurts — they also want to know how it feels, how strong it is, how long it’s lasted, and what makes it better or worse. Descriptions like stabbing, burning, aching, or throbbing can help narrow things down, as can tracking when the pain appears or changes.
Imaging and scans can help identify injuries or inflammation, but not all types of pain show up on tests. That’s especially true for neuropathic and nociplastic pain, diagnosis of which often relies on your history and symptoms rather than visible damage.
Sometimes, people experience more than one kind of pain at once — like nerve pain layered over joint pain — which makes finding the right treatment more complex. That’s why pain management often takes a team of experts, time, and careful listening.
Sometimes, different types of pain overlap — like nerve pain on top of joint pain — making treatment more challenging. Credit: Adobe Stock images.
Treating pain: from meds to mind tools
Pain treatment depends on what’s causing the pain and how long it’s been around. Acute pain often responds well to over-the-counter medications like paracetamol or ibuprofen, rest, ice packs, and gentle movement.
Chronic pain is more complex. Because it often involves changes in how the nervous system processes pain, it can’t always be ‘fixed’ with medication alone. Treatment might include prescription drugs like antidepressants or anticonvulsants (which affect how nerves fire), dietary changes, physiotherapy or other allied health supports, cognitive behavioural therapy, or mindfulness-based approaches.
Newer therapies are also emerging. Virtual reality is being used to retrain how the brain perceives pain. And researchers are exploring how certain spider venoms could block pain at its source without the risk of addiction that comes with opioids.
Pain management often involves a team — doctors, physios, psychologists, and researchers — working together to reduce pain, restore function, and improve quality of life. While not every treatment works for everyone, science is rapidly expanding the toolkit, offering new hope for those living with pain.
Chronic pain often needs a mix of medical, physical, and mind–body treatments. Credit: Adobe Stock images.
Two journeys through pain
Pain that doesn’t come from an obvious injury is often the least understood and hardest to treat. These two cutting-edge research projects are helping scientists rethink what pain is and how we might treat it.
A venomous breakthrough for gut pain
Irritable bowel syndrome (IBS) affects around one in five Australians, and many experience chronic abdominal pain without any clear injury. This kind of visceral pain often becomes nociplastic — the nervous system continues to send pain signals from special enterochromaffin cells long after the original trigger has passed. And people with an overactive connection between the gut and the brain are more likely to experience conditions like IBS, anxiety, and depression.
At SAHMRI (the not-for-profit South Australian Health and Medical Research Institute), researchers studying the gut–brain connection have used spider venom to identify specific pain pathways involved in IBS. What’s more, they’ve discovered how that same spider venom could be used to switch off those pathways. Unlike opioids (e.g. codeine, morphine, and oxycodone), which affect the whole nervous system and carry a high risk of addiction, these venom-based compounds target just the pain channels. This offers a safer, more precise way to block pain at its source.
SAHMRI researchers found spider venom compounds that safely block gut pain at its source. Credit: Getty images.
If you’re interested in learning more about SAHMRI’s research on IBS treatments, take a look at Stuart Brierley’s video that delves into new treatments for pain.
Virtual reality and the science of perception
What if your brain could be trained to feel less pain? That’s the question behind SAHMRI’s use of virtual reality (VR) to treat conditions like osteoarthritis and fibromyalgia. These forms of nociplastic pain aren’t caused by new injuries — they’re driven by how the nervous system processes and amplifies signals over time. And this is a key area of research for SAHMRI’s persistent pain research group.
SAHMRI medical research institute is using virtual reality to retrain the brain and reduce persistent pain. Credit: Getty.
In clinical studies, patients using VR headsets during movement-based therapy not only reported less pain, but also began to see their environments differently. One study showed that people with knee osteoarthritis often unconsciously believe movement will damage their joints, despite advice to the contrary from trusted medical practitioners, and they literally perceive the world as harder to navigate. Shifting their visual experience in VR helped reduce this effect. VR also distracted people from the difficulty of physical exercise, increasing their enjoyment and engagement in the activity, so they exercised harder and for longer.
These breakthroughs are part of a growing body of research showing that pain isn’t just something we feel — it’s something we can reframe. For a deeper dive into this fascinating science, here’s a video on how changing implicit beliefs can have a powerful impact on pain and health.
Rethinking pain, reimagining care
Pain protects us, but it can also overwhelm us. And science is showing it’s far more complex than we once believed. It can come from injury, faulty nerves, or a brain that’s stuck in alarm mode.
Researchers are learning not just how to block pain, but how to reframe it. That shift is helping people feel heard and guiding more personalised, compassionate care.
For anyone curious about the brain, the body, or how we care for each other, this is one of the most exciting frontiers in science.
Pain arises from injury, nerve dysfunction, or heightened brain signalling, and researchers are developing new approaches to understand, reframe, and treat it with greater precision and compassion. Credit: Getty.
Additional resources
If you’re interested in learning more about the innovative research featured in this article, here are several peer-reviewed research papers on the topics:
The voltage-gated sodium channel NaV1.7 underlies endometriosis-associated chronic pelvic pain
Selective spider toxins reveal a role for the Nav1.1 channel in mechanical pain