Amazing pain story – nail in the foot story

Story Time

A well-known pain story in the rehab world is the “nail in the foot” story that was published in the British Medical Journal in 1995.

So, the story goes...

A 29 year-old builder attended the emergency department at his local hospital after working on a building site and accidently jumping down onto a large 15cm nail. This man was in agonising pain and the Doctors at the emergency department had to give the man very strong painkilling drugs. However, every time they tried to move the nail he was screaming in pain and wouldn’t let them anywhere near him. Eventually, he was sedated and the Doctors were then able to remove the nail effectively. They pulled out the nail and removed his boot so that they could then access the wound and take appropriate care – but – the nail had landed between his toes and there was no injury! No blood! No puncture wound!

This story highlights one of the previous messages that pain does not correlate with tissue damage and that we can experience pain in the absence of damage! Instead, expectations and context play a huge role in a pain experience. This man had the expectation that a huge nail going through his boot would have caused damage and that he needed protection – his alarm system went off and he experienced pain! This does not mean the pain was not real. Pain is always real. No matter what.