
Pain perception can vary greatly. Sometimes, we feel pain more intensely than expected due to an injury or physical ailment but may feel less intense pain in other similar instances. This variability indicates that our perception of pain is highly dependent on our expectations and uncertainty.
Two hypotheses have been proposed to explain how the brain perceives pain. One is the estimate hypothesis, where the brain estimates the intensity of pain based on predictions. The other is the surprise hypothesis, where the brain perceives pain as the difference between prediction and reality, otherwise known as the prediction error.
In a new study published in Cognition, the mechanism underlying the perception of pain was investigated. In the experiment, healthy participants received painful thermal stimuli and reported felt pain intensity while observing painful or non-painful visual stimuli in the virtual reality.
The researchers found that the participants strongly perceived pain when the prediction error was large, demonstrating that the surprise hypothesis more adequately explains the pain perception mechanism in the brain. The study further confirmed that pain was amplified when unexpected events occurred.
People with chronic pain often experience vague pain-related fears and anxieties. Possibly, this uncertain gap between expectation and reality further increases the perceived intensity of pain. Therefore, reducing the gap between pain expectation and reality or “surprise” is important in reducing pain.
A better understanding of pain perception would facilitate the development of new treatments that would enhance recovery from chronic pain and trauma.
More information:
Ryota Ishikawa et al, Bayesian surprise intensifies pain in a novel visual-noxious association, Cognition (2025). DOI: 10.1016/j.cognition.2025.106064
Citation:
The brain perceives unexpected pain more strongly, study finds (2025, February 19)
retrieved 19 February 2025
from https://medicalxpress.com/news/2025-02-brain-unexpected-pain-strongly.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.

Pain perception can vary greatly. Sometimes, we feel pain more intensely than expected due to an injury or physical ailment but may feel less intense pain in other similar instances. This variability indicates that our perception of pain is highly dependent on our expectations and uncertainty.
Two hypotheses have been proposed to explain how the brain perceives pain. One is the estimate hypothesis, where the brain estimates the intensity of pain based on predictions. The other is the surprise hypothesis, where the brain perceives pain as the difference between prediction and reality, otherwise known as the prediction error.
In a new study published in Cognition, the mechanism underlying the perception of pain was investigated. In the experiment, healthy participants received painful thermal stimuli and reported felt pain intensity while observing painful or non-painful visual stimuli in the virtual reality.
The researchers found that the participants strongly perceived pain when the prediction error was large, demonstrating that the surprise hypothesis more adequately explains the pain perception mechanism in the brain. The study further confirmed that pain was amplified when unexpected events occurred.
People with chronic pain often experience vague pain-related fears and anxieties. Possibly, this uncertain gap between expectation and reality further increases the perceived intensity of pain. Therefore, reducing the gap between pain expectation and reality or “surprise” is important in reducing pain.
A better understanding of pain perception would facilitate the development of new treatments that would enhance recovery from chronic pain and trauma.
More information:
Ryota Ishikawa et al, Bayesian surprise intensifies pain in a novel visual-noxious association, Cognition (2025). DOI: 10.1016/j.cognition.2025.106064
Citation:
The brain perceives unexpected pain more strongly, study finds (2025, February 19)
retrieved 19 February 2025
from https://medicalxpress.com/news/2025-02-brain-unexpected-pain-strongly.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.