The individual feels pain at a location or area on their body. This is thought to be a function of the somaesthetic cortex,
a portion of the outer cortex of the brain in the temporal lobe.
This part of the brain is organised to represent the human body - like a map - called a homunculus (Fig.1 below).
Pain is a personal, private and therefore subjective experience.
Objective or shared understanding of pain comes from research about pain.
Believing the existence of pain in another person is a complex process which we usually take for granted.
Knowing the truthfulness of a pain report is the job of an external party - like your doctor.
The complexity of understanding pain involves most parts of human life, the complexity of the brain, our culture,
our upbringing, our accumulated experience of pain and suffering, along with how our memory functions.
The simplest representation of pain pathways relies on connecting the injuried area to the brain (Fig.2).
We know this is too simple. Today sophisticated electical circuitry and computer programming gives us a more powerful analogy of nerve function (Fig.3).
Pain reports that are considered false are those that do not match the underlying anatomy and physiology of nerve function (Fig.4).
Psychological disturbance, neurologic disease and ulterior motive are alternate explanations for not believing pain reports.
This logic lead to the first type of pain drawing analysis by Ransford (1976).
A number of criteria were used to suggest that "non-anatomic" influences (Fig.5).
Bryner (1998), and others have suggested that these criteria should not be used in this fashion.
Scientific evidence of pain sources has changed substantially over the last 30 years.
Mechanisms of referred pain can explain the apparent mismatch between source and pain reported at another location.
Patients often feel affronted that their pain report has been dismissed as "psychosomatic", or its "all in your head". The truth probably lies between the two extremes:
Some reports are genuine, but atypical and others are either fake, or severely exaggerated due to processing/higher centre events.