New Neuroscience & What It Means for Treatment & Healing:
My own journey with chronic pain has informed my practice immensely over the years, and I am very excited to share some new things that have helped me (and hopefully already some of you) in big ways recently. This article is about:
What IS pain, actually? Continuing to learn and hone my understanding has made a world of difference in how I approach my own pain, sensations and healing process, as well as fundamentally changed my bodywork practice—especially how I've been working with people with chronic symptoms. I expect (I hope!!) we will see a slow but steady change in the medical and bodywork worlds to reflect this new scientific understanding of the neuroscience showing us that that pain is created by the brain, not the body. Whaaaat? If you wonder why chronic pain is one of the most pervasive health issues of the modern world, and no one seems to be figuring it out with conventional treatments... here's my guide on where to start.
Chronic pain/symptom resource list and links - the list I wish someone had given me! Education, stories, videos, podcasts, books and practices for healing chronic symptoms (including resources for dizziness/vertigo, migraines, fatigue, brain fog, long covid, anxiety, tinnitus, POTs, EDS, and many more). Skip right to resource list here.
Some Important Notes & Disclaimers:
Since this is an emerging field (the science and studies behind what I'm about to share come from the last 20-ish years, conducted all around the world), the terminology has not yet coalesced around singular terms. For example, "neural cuircuit" pain/symptoms are sometimes also called "primary" or referred to "pain system hypersensitivity". I want to credit the work of Lorimer Moseley, David Butler, Alan Gordon, Alon Ziv, and Dr. Howard Schubiner (among many, many others, including Dr. John Sarno, who was so far ahead of his time).
What follows is definitely oversimplified... I wanted to fit this into an article that folks would actually read! Many detailed books are written about this stuff, but I hope this can be illuminating even if cliff-notes-y. I urge you also to keep an open mind, as some of this might challenge what you have thought to be how things work.
I will mostly use the word "pain" below, but you can insert most chronic symptoms or sensations into its place. See resource link at bottom for more about other symptoms/sensations, including a quiz for helping self-assess whether you might have nervous system-created/maintained symptoms (even if you've been diagnosed with structural issues).
So, What IS Pain, Actually?
The body speaks in sensation and experience, not words. Pain is like the body's fire alarm, trying to get your attention—but what is it pointing to? What is especially tricky about this, and why millions of people are seen by doctors every year who cannot explain their pain, is that the thing that is bothering you is not necessarily what or where the issue is. This can be a challenge intuitively, because if my foot hurts, I naturally look for what's wrong with my foot. But how pain is created is much more layered and complicated, specifically with chronic pain.
Some essential pain facts:
1. Pain is created by the brain ...not the body's tissues! It is an interpretation by your central nervous system based on your biology (the messages coming from your body), your psychology (your thoughts, beliefs, and understandings of what is happening), and your social context (polyvagal theory shows us that we are fundamentally social creatures and our sense of safety largely comes from our sense of connection, belonging, trust, and stability).
2. Pain is not an accurate measure of tissue health. Studies show: you can have pain without anything physically wrong; and you can have things physically wrong without any pain! Think about phantom limb pain, and people who are injured but feel no pain while escaping a dangerous situation or experiencing shock... the pain kicks in later.
3. Pain's function is to protect us from putting ourselves in more danger, usually physically (i.e. if you've burnt your mouth on scalding hot soup), but because we are talking about ONE nervous system, this can also mean that stressors in our life (like finances, work, relationships, loss, transitions, etc) that create stress can lead to pain sensations (i.e. if your back tightens up or "goes out" before a huge work presentation).
Pain is just one way the body lets us know that our brain/nervous system is worried about some kind of danger/stressor and wants us to pay attention, stop or slow down. Other ways it lets us know are fatigue, dizziness, migraines, cramps, panic attacks, brain fog, etc. (See resources for more full list.)
Because pain's function is protective, when we experience stress or pain chronically or persistently (typically, anything over 3-6 months), our nervous system gets better at sensing/producing stress and pain experiences—all in service keeping an eye out for danger and keeping you safe. Pain System Hypersensitivity goes hand-in-hand with anxiety, stress, and/or an overstimulated, highly sensitive nervous system more generally. Your inner guard dogs sensed something was off and are now on high alert, sniffing more more trouble.
Nothing is wrong with your body, and all pain is real. Your nervous system is doing what it is designed to do... it's just gotten carried away with its protecting job.
In this way, persistent pain actually over-protects us and can prevent healing. Because pain/stress/stimulation/anxiety all run on the same nervous system, the pain-stress loop that can get created means that symptoms can persist long after any injury may have occurred. It's common to stop moving and doing activities (out of fear of increased pain) in the ways the body actually needs in order to get the feedback to feel safe again.
So how do we approach back pain that is not actually, at the root of it all, about your muscles, spine, or physical structures? This is where a holistic mind-body nervous system approach is essential. We have to take an active role in addressing the many ways we experience, create, manage, and release stress, on physical, mental, emotional and social levels.
May My Chronic Pain Journey Resource Yours
You may or may not know much about my own journey with chronic pain and tension. It is the main reason I am a bodyworker today. Bodywork and nervous system education/practices have been the best tools I've found to help me to manage my pain, stress, and feel like the most functional, best version of myself... and I am up-leveling my toolbox.
This new pain neuroscience is a revelation—because dealing with the pain (plus the uncertainty, not-being-able-to-figure-it-out, doing so many of "the right things" but still having flare ups) was really hard, and was showing me that I was still missing something important. Recent studies have estimated that chronic pain takes a similar emotional toll to a cancer diagnosis.
I will share more of my own story in a future article, but I wanted to begin with sharing the resources that have made the biggest difference for me.
How to work with this list:
Start with what calls to you and feels most important, trust you will be called in the right direction. And if something doesn't resonate, look somewhere else. Please share these far and wide. Persistent pain impacts 100 million adults and costs from $560 to $635 billion annually1.
If you feel overwhelmed by the list, I recommend starting with the 5-minute Tame the Beast video (will help solidify some of what I shared above), and order yourself a copy of the Explain Pain Protectometer Handbook.