Pain begins with signals from the body. When tissue is irritated or injured, specialised receptors send information through the nervous system to the brain. These signals carry details about pressure, inflammation and possible damage.
The brain then processes this information and decides whether it should be experienced as pain. As such, pain reflects not only the physical signals coming from the body, but also how the brain interprets it.
Signals from muscles, joints, skin and organs are constantly being sent to the brain. But the brain does not simply relay this information unchanged. Instead, it evaluates these signals and decides how strongly they should be felt. Pain, therefore, is not just detected by the brain, but produced by it.
How Does the Brain Shape Pain?
When the brain receives signals from the body, it does not interpret them in isolation. Instead, it evaluates them within the wider context of what is happening at that moment- asking questions such as: Is this dangerous? Does this require immediate attention? Based on this, the brain can increase or reduce the intensity of the pain signal.
For instance, if someone were running from a serious threat and cut their hand on a branch, they might barely notice the injury at the time. The brain recognises that survival requires attention elsewhere and temporarily reduces the pain signal. Once safety is restored, the pain may suddenly become more noticeable.
By contrast, the same cut to your hand while calmly preparing food in the kitchen may feel immediately sharp and intense. The injury itself may be similar, but the brain interprets the situation differently and modulates the experience accordingly.
Pain is therefore shaped not only by physical signals from the body, but also by the brain’s interpretation of those signals- a process influenced by both neurological activity and psychological context.
Why Can Pain Become Chronic?
The brain also has systems designed to regulate how much pain we feel. These systems normally help filter sensory signals so that not every sensation from the body becomes painful.
In chronic pain, this filtering process can become less effective.
When the nervous system repeatedly receives signals associated with stress, injury, illness, or prolonged strain, the brain can become more sensitive to incoming information from the body. Signals that would normally be filtered out may begin to register as pain- this can explain why chronic pain can sometimes persist even when medical tests do not show ongoing damage.
How Can Trauma Influence Pain?
Experiences of trauma can influence how the brain evaluates safety and threat.
The nervous system is constantly scanning the environment for possible danger. After trauma or prolonged stress, the brain systems responsible for detecting threat can become more reactive. Research has shown that repeated exposure to threat can produce measurable changes in the brain: regions involved in fear and threat detection may become more active, while areas responsible for regulating those responses may become less effective.
When this balance shifts, the brain may begin interpreting ordinary or harmless bodily sensations as potential warning signals. Pain can then emerge as part of this response.
From the brain’s perspective, the signal is still protective; an attempt to keep the body safe. But when these threat-detection systems become overly sensitive, the pain signals they generate can become persistent.
This is one of the reasons trauma is increasingly recognised as a contributing factor in some chronic pain, particularly when symptoms cannot be fully explained by physical injury alone.
How Can rTMS Help with Chronic Pain?
If chronic pain is partly influenced by how the brain processes and regulates signals from the body, supporting the nervous system itself becomes an important part of treatment.
Rather than simply trying to push through pain or suppress symptoms, the aim is to help the brain recalibrate how it interprets signals from the body and environment.
Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive neuromodulation treatment designed to influence activity within specific brain networks and promote neuroplasticity.
In rTMS treatment for chronic pain, magnetic pulses are delivered to targeted areas of the brain involved in pain perception, emotional regulation and threat processing. By repeatedly stimulating these circuits, rTMS may help stabilise the networks that influence how pain signals are generated and interpreted.
Research into rTMS for chronic pain suggests that regulating these brain networks may reduce pain intensity and improve function for some individuals.
At Naya Health, an rTMS clinic in London, treatment focuses on supporting the brain systems involved in pain regulation and threat perception. By helping the nervous system move away from persistent threat signalling and toward more balanced regulation, rTMS may support improvements in chronic pain symptoms over time.
For individuals living with persistent or unexplained pain, this perspective offers an important shift: the pain is real, but the brain networks producing it may be capable of change.