The Surprising New Science Behind Chronic Pain

Pain Is A Protector

Pain is a danger signal⚡. It protects us from further damage—to make us remove our hand from something hot, to stop us walking on an injured ankle, to make sure we take time to let injuries heal.

The latest research shows that most forms of chronic pain don’t stem from physical problems in the body, but from learned neural pathways in the brain.

What does that mean? Essentially, when you experience chronic pain or symptoms, especially over a longer period of time or during times of stress, your brain gets really good at ‘protecting’ you by sending pain or symptoms. It gets into a habit and can become overprotective and oversensitive — so the slightest thing can trigger it.

All Pain Is Real

All pain is real and the brain processes all of it—but pain circuits can get ‘stuck’ and misfire, sending pain signals even when there’s no real need.

Chronic pain affects more than 1 in 5 adults worldwide. For decades, most people have assumed it always comes from injury or ongoing physical damage.

But a growing body of research is now revealing something far more complex—and far more hopeful.

Pain Is Not Always a Sign of Damage

Most of us have been conditioned to think that pain equals harm and so we naturally look for a physical cause and explanation. This makes logical sense most of the time.

• If your back or neck hurts, or have other musculoskeletal pain, you assume there must be something wrong with the bones, muscles or nerves. And you might expect an MRI or scan will find this ‘root cause’ so it can be sorted.
• If you’re experiencing Burning Mouth Syndrome, you’ll wonder if it’s your hormones, something wrong with the jaw or mouth to explain the excruciating pain.
• If you have trigeminal neuralgia, you might look everywhere—is it a tooth, an infection, a damaged nerve, or something wrong with the ear?—as you look for a potential cure.

But modern neuroscience tells us a different story: pain is not an accurate measurement of tissue damage. It’s an output from the brain—a protective signal based on a mix of physical, emotional, and environmental cues.

That means you can experience severe pain without any injury at all. (Phantom limb pain is a good example of this and illustrates how the brain is responsible for our pain experience..)

And the opposite it also true—you can have major structural issues (like a herniated disc) and feel no pain whatsoever.

And frequently with chronic pain, you’ll discover that there is nothing structural or physical wrong with your body at all. Nothing is broken. There are no ‘issues in the tissues’.

Basically, the brain decides whether or not we feel pain or symptoms. It’s calling the shots.

Predictive Coding: The Brain’s Role in Chronic Pain

One of the biggest breakthroughs in recent years is the understanding of neuroplasticity — the brain’s ability to rewire itself. In chronic pain, the brain can essentially get “stuck” in a pain loop, This is particularly common in conditions like fibromyalgia, migraines, and long-term back pain.

Even more surprising? Your thoughts, beliefs, and past experiences can all shape how your brain processes pain.

And the good news is that it is possible to rewire the brain and teach it that the pain or symptoms are no longer required.

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The Shift Towards a Whole-Person Approach

Thanks to this evolving science, chronic pain treatment is shifting from a strictly biomechanical model (focused only on the body) to a biopsychosocial model, which considers the whole person—body, mind, and environment.

New interventions include:

• Pain neuroscience education: Teaching people how pain works can significantly reduce symptoms.
• Mind-body therapies: Mindfulness, cognitive-behavioural therapy, and somatic tracking help retrain the brain’s pain pathways.
• Movement without fear: Gradual exposure to movement helps reverse the brain’s overprotective responses.
• Addressing trauma and stress: Emotional and psychological factors often play a hidden role in chronic pain, and addressing them can unlock healing.

Pain Reprocessing Therapy

Pain Reprocessing Therapy uses neuroscience-based techniques to reduce—and in some cases, even eliminate—chronic pain or symptoms. They take advantage of the brain’s neuroplasticity to train it to build a new neural pathway—one without pain or symptoms.

You might be thinking that this sounds too good to be true. But multiple research studies are starting to show the effectiveness of this approach.

Researchers in the Boulder Back Pain study at the University of Colorado (Ashar et al, 2022), randomly assigned 150 back pain patients (who had chronic back pain for an average of 9 years) to the following treatment groups:

◾ 50 patients received 8 sessions of PRT (Pain Reprocessing Therapy)

◾ 50 patients received an open-label placebo injection (no medicine)

◾ 50 patients were the control group (usual care; no additional treatment)

98% of the PRT group improved. By the end of treatment, 66% of participants in the PRT group reported being pain free or nearly pain free, and most maintained these improvements at the one-year follow-up.

‘Pain free or nearly pain free’ means that participants reported a pain intensity score of 0 or 1 of 10. Think about the difference that would make for a moment…

What does Pain Reprocessing Therapy Involve?

PRT is a type of talking therapy which takes a holistic approach and involves:

🧠 Education about the latest pain science and neuroplastic pain

🧠 Retraining the brain and body to respond differently to pain

🧠 Addressing thoughts and emotions, such as fear and frustration, which fuel the pain

Recovery Is Within Reach

If you or someone you love is living with chronic pain, this new science offers a powerful message: there is hope. The nervous system can change. The brain can change. Relief and recovery are within reach and may be even closer than you think.

Read how these approaches have helped clients take control of their lives again on the Client Testimonials page.

Please feel free to get in touch to discuss how I could support you.

#chronicpain #PRT #neuroplasticpain

References:

Ashar et al ‘Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial’ JAMA Psychiatry, 2022.