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Boot Nail Guy: When Pain Isn’t About Injury
Your pain is an output from the brain.
7/19/20251 min read
Have you heard about the Boot Nail Guy — a construction worker who became the poster child for “pain without injury.”
The story? He jumps down onto a 15 cm nail. He’s in agony. They sedate him. Pull the nail out. Remove his boot... and discover the nail went cleanly between his toes. Not a scratch.
Originally published in a 1995 British Medical Journal, the case has become a famous example of how pain can be generated not by damage, but by the brain’s perception of threat.
It’s not a rigorous case study — more anecdote than evidence. But it raises powerful questions:
Was it real pain or just panic?
Can the brain create pain when no nociception (injury signal) is present?
And if so, how often does this happen?
The story illustrates a core idea in modern pain science:
Pain isn’t just a body signal. It’s a brain decision.
When fear takes over, pain can follow — even without an actual injury. That’s the nocebo effect: grief from belief.
Other examples? Beets mistaken for blood. Phantom limb pain. All signs that perception, not just damage, drives our experience of pain.
So yes, Boot Nail Guy may be imperfect — but his story still sticks the landing.