Chronic Pain 
the Brain

What Neuroplastic Pain is and how knowing about it could change your life

The human brain plays a key role in the intensification and generation of chronic pain and other symptoms.  

We're here to help you understand what's really happening, so you can start your journey with confidence.  

So let's start from some basic neuroscience of pain!

What is Acute Pain?

Let's say you sprain your ankle playing basketball. Nerves in your ankle will send messages (electrical impulses) to your brain telling it there's something wrong. Receptors in your brain (neurons) receive these signals and cause you to feel pain to keep you from injuring it further.  
Acute pain can arise if you:

  • Break a bone 
  • Have an infection   
  • Have a tumor  
  • Suffer blunt trauma  
  • Burn or cut your skin, etc. 

What about Chronic Pain?

Chronic pain is when the pain signals continue to fire regardless of whether something is structurally wrong. Here are some markers for chronic pain (Source: Cleveland Clinic)

  • Chronic pain is pain that lasts for over four months.
  • The pain can be there all the time, or it may come and go.
  • It can happen anywhere in your body
  • Continues long after you recover from an injury/illness OR 
  • Can happen for no obvious reason 
  • Can prevent you from doing hobbies or basic tasks 

Chronic Pain is a Global Crisis! 

Sound familiar? If so, you're not alone.

In 2011, 100 million adults in the US alone suffered from chronic pain. That's almost 50% of American adults. Chronic pain affects 1.5 billion people globally (1 in 5!)

In the United States, chronic pain affects more people and has a greater economic cost than heart disease, diabetes and cancer combined. The cost of Chronic Pain in the US has increased 1035% in the past 25 years.  

And unfortunately, reputable science shows that conventional treatments to chronic pain provide little help.

  • Pain Medication: there is "little or no evidence that [pain medication] makes any difference to people's quality of life, pain, or psychological distress." - UK National Institute for Health and Care Excellence
  • Physical Treatments: "Overall, currently available treatments provide modest improvements in pain and minimum improvements in physical and emotional functioning" - The Lancet
  • Surgery: "Surgery has been found to be helpful in only 1 in 100 cases of low back problems. In some people, surgery can even cause more problems" - U.S. Department of Health and Human Services

There is of course a place for each of these therapies.

But when it comes to long-term, persistent chronic pain, there is little evidence to support using these treatments.

And this is leaving people hopeless and disempowered.

What actually causes chronic pain?

Today, the science shows that chronic pain often has to do with specific responses in the brain.

In his book The Way Out, which is based on a studies using neuroimaging to observe the brains of people with chronic low back pain, Alan Gordon explains that chronic pain is associated with the brain regions responsible for learning, memory, & emotion.

Your brain learns to be in pain, the same way you learn how to ride a bike, or learn how to drive a car. 

And chronic pain more to do with emotions that are being generated than it does with somatic processes in the brain.

They found that with acute pain (caused by a structural issue), there was more activity in the brain in bodily-sensing areas. With chronic pain, there was more brain activity in the emotional sensing areas.

The brain can get stuck in pain because of:

  • Painful events - Traumatic events can create real, physical changes in the brain. This is especially true if the person has received little to no support at the time of trauma.
  • Fear of the pain itself - Fear activates similar brain regions that are also linked to the generation of pain signals.
  • Expectation of pain - Anticipating pain after specific movements or activities initiates a conditioning process. Based on previous memory, the brain can re-activate pain signals even in the absence of injury.
  • Perceived threats - These include painful or stressful situations that cause the individual to be in a high state of tension for long periods of time (e.g. being in a long-term abusive relationship, living in fear, under pressure or worry for long periods of time).

What is Neuroplastic Pain?

When there is no injury or underlying illness causing it, chronic pain is often 'neuroplastic', which means that it is generated by changes in the brain.

Dr. John Sarno, who popularized the mindbody connection as it relates to chronic pain, called neuroplastic pain Tension Myositis Syndrome, and later adapted to Tension Myoneural Syndrome. It has also been referred to as PPD, Psychophysiologic Disorder, or The MindBody Syndrome. 

All of these terms are interchangeable and describe the same thing: symptoms generated by the brain.

 Unfortunately, very few medical professionals and specialists know how to identify and address neuroplastic pain. Despite the fact that over 1 billion people worldwide are affected by chronic pain, medical doctors spend an average of only 11 hours learning about pain in Medical School (Gordon, The Way Out, 160)! 

Instead, the focus remains on treating the symptoms in isolation, and on 'managing' the pain through physical therapy, exercise, drugs or other pain relief techniques, which have been proven to be largely ineffective (see above).

How do you treat neuroplastic pain / TMS?

Neuroplastic pain is 100% psychological, which means that the solution lies in working with the nervous system (the system that sends communication messages between the brain and the body). Essentially, the aim is to get the brain to unlearn the pain response.

There are various techniques used to faciliate this process. A dysregulated nervous system plagued by chronic stress requires a shift towards more peace and balance. Negative emotions that have accumulated over time may need to be explored and acknowledged. In some cases, trauma work is necessary, but in the majority of situations, it is enough for the individual to become aware of the emotional stressors that are causing the symptoms.

We agree with Dr John Sarno that the best cure is 'education'. Knowing and understanding what's going on in one's mind and body can initiate relief and a radical shift in perspective, and this in itself will initiate a brain rewiring process. This typically paves the way for relaxation and for regaining trust in one's body.

However, healing neuroplastic pain also requires a good amount of consistent application. This is because chronic pain sufferers need to unlearn certain unhelpful beliefs and habits. They need a safe space in order to challenge current limitations to avoid overwhelm and fear.

Healing often involves a radical change in beliefs, perspective and identity. However, it doesn't need to be complicated either!

Chronic Pain Myths vs. Scientific Facts:
Challenging conventional wisdom of chronic pain 

FACT: Pain can be present without physical abnormalities.

In a recent study of back and neck pain sufferers, 98% had a ‘structural abnormality’ that showed up on an MRI. However, in only 5% of cases was that abnormality purely responsible for the pain. And 88% of cases, it was entirely the brain!  

In a study done by the Royal College of Psychiatrists in 2001, more than half of patients seen by specialist doctors (cardiology, neurology, gynecology, etc.) had symptoms that defied physical explanation. Meaning there was no physical explanation for the pain! 

FACT: Physical abnormalities can be present without pain.

Consider these surprising stats from competitive/pro athletes who push their bodies constantly:

Rotator Cuff: 40% of elite overhead athletes have partial or full tears of their rotator cuff - but no pain. None of the athletes interviewed 5 years later had any subjective symptoms or had required any evaluation or treatment for shoulder-related problems during the study period.

Knees: 50% of asymptomatic Pro NBA players have lesions on their knees and they were pain-free

Hips: Two-thirds of collegiate and pro hockey players have degenerative changes in their hips and have no symptoms.

Shoulder: 80% of elite level rock climbers without shoulder symptoms have shoulder abnormalities.

FACT: Rates of some chronic pain conditions actually level off with age. 

The proportion of the population that has back or neck pain does not rise linearly with age. It rises from the 20s to the 50s, and then levels off.

If chronic back and neck pain were due to 'wear and tear' from getting older, then rates would continue to go up with age. 

FACT: Emerging treatments that change the brain's neuroplasticity work extremely well, and have helped and healed tens of thousands, including us and our clients. 

There is help for neuroplastic pain!

There is hope! Mindbody approaches, like our Pain Free Comeback Program have had exceptional results in reducing, or even eliminating chronic pain of a neuroplastic origin.

And if we go back to Dr John Sarno's initial mindbody treatment for chronic pain, 88% of patients with herniated discs were pain free 3 years later (Dr. John Sarno, 1987).

In a more recent study, the Boulder Back Study, 66% of patients were pain free or nearly pain free after undergoing pain reprocessing therapy, which is focused on a 100% psychological approach to chronic pain (Yoni K. Ashar et. al, 2021).

 Similar outcomes have been found for sufferers with ankle, hip, knee pain, migraines, etc. 

We’ve personally worked with numerous people who have made remarkable recoveries.

Check out more information about our unique Program by clicking the link below.

Frequently Asked Questions (FAQ)

We’ve developed a free, unique and personalized chronic pain questionnaire.

Within 5 minutes, it’ll reduce fear, unlock hope, and expose you to a new brain-focused way of healing that you probably haven’t encountered before.

In addition, if there are still diagnostic tests that you feel you should take. You should take these first to eliminate serious medical conditions that require essential treatment.

If you have had all the tests and found no reason for your symptoms OR, if your symptoms were blamed on a structural condition but you have found no effective treatment for it, then it is likely that your pain is brain-generated. 

Your pain is real, just as all pain is real. You're NOT weak, sick, crazy, imagining this pain, or consciously deciding for it to happen! 

All pain is created in the brain, either in the immediate response to a physical injury, or in the case of chronic pain, because of over-active neural circuits in the brain. It is not your fault.

The great news is that brain-generated pain is learned, which means it can also be unlearned. 

So were we, and so were almost all of our clients. This is a common thing that doctors tell people, but most structural problems are 'incidental', which means that they actually have nothing to do with the pain itself.

While it’s important to get a physical examination to rule out fractures, tumors, infections, etc., blaming chronic pain on a structural abnormality is often like blaming migraines on grey hairs.

In fact, in a recent study of back pain sufferers, 98% had a spinal 'abnormality' on their MRI, but only in 12% of cases were these abnormalities actually causing the pain! The other 88% of sufferers had pain caused by neural circuits.

Consider also that 30% of 20-somethings without any back pain have herniated discs. 84% of 80-somethings without any back pain have herniated discs! 

We know that genetics can play an (often small) role in certain chronic pain conditions. However, these are predisposing factors - they do not cause the symptom onset.

Symptom onset occurs when those genes are activated or triggered, generally through fear, anxiety, chronic stress, or injury. It's far more likely for the child of a back pain sufferer to have back pain NOT because of genetic predisposition, but because the exposure to a trusted figure with pain conditions predisposes the child to adopt very specific beliefs (e.g. the back is "weak" or certain physical activities are dangerous). This conditioning (based on very strong expectations) is 'priming the pump' for pain to occur later in life.

We also know that although genetic evolution can take thousands of years, we can alter gene expression in a short amount of time. For example, studies show that meditation can alter your gene expression in a positive way in a very short amount of time. This means that genes that are activated can be deactivated. And chronic pain symptoms are often reversible because the neural-circuits causing pain can be deactivated. 

You had a bad injury years ago - but it may not be why you still have pain TODAY. Accidents and injuries occur. However, the human body has an incredible ability to heal - from broken bones, ligament tears, etc.

Consider that the biggest bone in the body, the femur, can heal - and actually become stronger than before the fracture - in just 8 weeks!

What often happens is an injury can transition from being 'acute' to 'chronic' through fear, worry, and the activation of neural circuits.

If we took an MRI of your brain right after your accident, it would show pain in the brain regions associated with bodily feeling. However, after a certain number of weeks, when pain persists, other brain regions light up - ones associated with emotions, learning, and memory! The pain then becomes learned - like a bad habit.

Here's an interesting fact: despite an average number of car accidents, whiplash doesn't exist in Lithuania! Studies have also found that neck pain can be generated by a simulated car accident - just because the person's brain is 'fooled' into thinking it's been damaged!

Pain is often not due to ongoing injury from an accident that happened years ago, but neural circuits driven by fear, anxiety, and worry. And these neural circuits can be turned off, no matter how long you've been in pain. 

This is very common. In the case of chronic pain, these areas of muscle tension are generally caused by a build up of emotional tension. They are a symptom of pain, rather than the primary cause of pain.

Just think about this: if you're stressed and tense, then the body is going to tense up. This is a normal response that equips us to deal with emergency and high pressure situations. However, if we are unable to relax after the stress is over, than we may keep holding on to this tension.

As the nervous system is calmed through neural circuit retraining, these areas of muscle tightness go away, along with the pain. 

This is also very common. Many people have pain or symptoms that are generated by movement, activity, weather, heat, cold, light, sound, certain people, foods, or pressures. In each case, these are triggers not causes of chronic pain.

Like Pavlov, who taught his dogs to salivate by ringing a bell without food, your brain learns to associate symptoms with these activities. This is conditioned, and can be unlearned. These triggers also generate symptoms outside of our conscious awareness.

Research shows that most decisions are made subconsciously, and we make subconscious associations all the time. Consider that you are more likely to rate someone's behavior as disagreeable if you are exposed to a strong smell, and you're more likely to say someone is likable if you're holding a warm cup of liquid.

In the same way, you don't need to be consciously aware of these triggers (e.g. that the weather has changed or that you've moved in a certain way) in order to experience conditioned neuroplastic pain.