Pain Feels Worse When You Don’t Expect It—Here’s Why

When we touch something familiar, such as a warm pan, our brain already knows what to expect. This expectation helps us gauge the level of pain we might feel. However, if we were blindfolded and touched the same pan without knowing what it was, the pain might feel more intense—even if the temperature was not high enough to cause harm. A recent study from Aarhus University’s Department of Clinical Medicine shows that uncertainty in what we are about to experience can amplify pain perception, making it feel worse even when there is no real danger.

The Experiment: Understanding Uncertainty and Pain

The study, published in Science Advances, explored how uncertainty affects pain perception. Researchers asked participants to predict whether they would feel a warm or cold sensation on their forearm. However, in some cases, they were exposed to both sensations at the same time. This combination triggered a burning sensation, a known phenomenon called the thermal grill illusion.

Associate Professor Francesca Fardo from Aarhus University explains, “Previous research has shown that our expectations influence how we experience pain. In this study, we wanted to determine if uncertainty—when the brain does not have a clear expectation—could also amplify pain perception. By using the thermal grill illusion, we found that even when no harm is occurring, uncertainty makes people feel a high level of pain.”

Brain Imaging Confirms the Link Between Uncertainty and Pain

To investigate further, researchers used advanced brain imaging techniques and computer modeling on 300 participants. The results revealed that uncertainty triggers activity in specific areas of the brain, intensifying pain perception.
Fardo explains, “We already know that expectations can influence pain—believing that something will hurt can make the pain worse while expecting relief can lessen it. Our study adds a new perspective: when the brain is unsure about what will happen, it assumes the worst, increasing the pain response unnecessarily.”

Implications for Pain Management

These findings could have a significant impact on how pain is treated, especially in medical and therapeutic settings.
“In the short term, this study helps pain researchers better understand how pain perception works. More importantly, it suggests that healthcare providers might be able to improve pain management by providing clearer information and setting accurate expectations for patients. This could help reduce uncertainty and, in turn, lower pain perception,” Fardo notes.

When Interventions Work Best

The researchers found that the best time to make lifestyle changes for better brain health is between the ages of 48 and 70. During this period, improving diet and managing weight can have the most significant impact on preserving cognitive function in later years.

Conclusion

The next step for Fardo and her team is to conduct similar studies on individuals with chronic pain. They also aim to explore how psychological factors, such as anxiety and depression, influence pain perception.
By better understanding the role of uncertainty in pain, scientists and medical professionals may be able to develop more effective treatments, ultimately improving patient care and quality of life.

Source: Inputs from various media Sources

I’m a pharmacist with a strong background in health sciences. I hold a BSc from Delhi University and a pharmacy degree from PDM University. I write articles and daily health news while interviewing doctors to bring you the latest insights. In my free time, you’ll find me at the gym or lost in a sci-fi novel.