A new view of pain as a homeostatic emotion
Six pages on PainSci cite Craig 2003: 1. Pain is Weird 2. Chronic Pain as a Conditioned Response 3. Cognitive Behavioural Therapy for Chronic Pain 4. Mind Over Pain 5. Amnesiac glutes, history of pain, and rates of anxiety with pain 6. Pain as a homeostatic … emotion? (Member Post)
PainSci notes on Craig 2003:
In 2003, Craig documented the evidence and rationale for his hypothesis that pain evolved as part of the system that feels and reacts to internal physiological conditions to maintain homeostasis, making pain “a specific emotion that reflects homeostatic behavioural drive, similar to temperature, itch, hunger and thirst.” This differed from the conventional view of pain as a kind of (exteroceptive) touch sensation, and that remains the case in 2025. His hypothesis has a number of potentially powerful explanatory implications.
Interestingly, primates process this information in the brain, whereas the pathways in all other animals ascend only to the brainstem, suggesting that pain is more integrated with psychology. This may be why Craig used the term “emotion.”
Unsurprisingly, Craig’s work has been interpreted — and likely over-interpreted — as “the background for our contemporary understanding of mind–body therapies” (Mehling, 2024). But treatments like meditation, yoga, and cognitive behavioural therapy have not — repeat, not — panned out as clearly effective.
While Craig’s research sheds interesting light on the relationship between pain and psychology, it’s quite high-level, and definitely doesn’t necessarily mean that the mind can relieve pain any more than you can stop feeling seriously overheated or thirsty with a shift in mental perspective.
I explore the study in more detail in a members-only blog post. And if you’re even more interested, Craig published a book in 2015: How do you feel?
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Pain is conventionally viewed as a pattern of convergent activity within the somatosensory system that represents the exteroceptive sense of touch. Accumulating functional, anatomical and imaging findings indicate that pain is generated by specific sensory channels that ascend in a central homeostatic afferent pathway. Phylogenetically new thalamocortical projections in primates provide a sensory image of the physiological condition of the body and, in addition, direct activation of limbic motor cortex. These findings indicate that the human feeling of pain is both a distinct sensation and a motivation - that is, a specific emotion that reflects homeostatic behavioral drive, similar to temperature, itch, hunger and thirst.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Restoring trust in menopause management: menopause hormone therapy is not a panacea, and physical activity remains a critical intervention. Tulloh 2025 Br J Sports Med.
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.