“Pain is pain, and it’s always real.”
– Alan Gordon (The Way Out: The Revolutionary, Scientifically Proven Approach to Heal Chronic Pain, 2021)
All too often, individuals who are struggling with chronic pain are made to feel as though their experiences of pain are not real, or are not fully believed.
This messaging isn’t always obvious, and can be conveyed unintentionally though questions and comments like …
→ The good news is … there’s nothing wrong!
→ You shouldn’t be experiencing that.
→ Have you been feeling stressed recently?
The reality is that pain is pain – whether it stems from mechanical damage or not. Pain is processed in the brain, and our brains have incredible influence over where, when, and how much pain we feel.
What are pain signals?
This is where advice telling us to simply ‘ignore the pain’ (suggesting it is ‘all in our heads’!) can be especially unhelpful. Pain signals are our brain’s way of telling us that something is wrong; of signaling danger. And, like all danger signals, it is designed to be impossible to ignore. Alan Gordon puts it this way- “when your body tells you there’s a problem, it makes sure you listen.”
After all, what good would these signals be to our survival if we could easily push them aside?
Do pain signals always indicate danger?
Have you ever experienced a false alarm?
Perhaps you smelt smoke, but it turned out to be just your neighbours having a BBQ? Or you heard your child yelling from the next room, but it was all part of a game they were playing? Or the fire alarm went off at work, but it was only triggered by some burnt toast?
When an alarm is raised – be that through a sound, or a smell, or some other signal – our bodies are wired to react accordingly. We go into a state of high alert and take action to keep ourselves and our loved ones safe.
This is what our experience of pain is like. When we injure ourselves, the body sends signals to the brain informing us of tissue damage, and we feel pain.
Pain is a danger signal – but there are times when these signals can be a false alarm too. Our brains aren’t perfect, and sometimes they misinterpret safe signals from the body as if they were dangerous. This is especially true if we react with fear, doubt, frustration, upset, or alteration to our normal routines when the signal is raised again and again. This is known as ‘neuroplastic pain’ and is often the result of pain that the brain has learnt.
It’s important to note that the term ‘false alarm’ doesn’t mean that the pain experience isn’t real. What the pain signal is reporting might not be entirely accurate, but the feelings of pain being processed by the brain are real and can still be experienced as chronic pain.
What causes neuroplastic pain?
Neuroplastic pain is not experienced as the result of structural causes, but of psychophysiologic processes that can be reversed. When the brain experiences pain repeatedly, those neurons get better at firing together. This means that the brain can become more sensitive to feeling pain … and, if it gets too good at ‘sensing’ pain, the brain changes and begins to reinforce chronic pain. This can be especially true when our brains begin to connect certain activities, environments, postures, situations, or triggers as those likely to cause pain; our brains begin to predict and expect pain at these times and set off the alarm!
Neuroplastic pain can be addressed, and hopefully alleviated, with psychological support. Brain imaging studies have demonstrated that the pain experienced is very real, as the result of learned neural pathways in the brain. Just as the pain has been learnt, it can also be unlearnt.
How do you know if your pain is neuroplastic?
If you’re wondering if your own experience of pain could be, at least in part, neuroplastic then there are a number of things to look out for. Here are some signs that your chronic pain could be lessened, if not possibly eradicated:
→ Pain started during a stressful period in your life
→ Pain began without injury
→ You have a wide range of symptoms
→ There is no physical diagnosis for your pain
→ Pain is heightened during times of fear or anxiety
→ Symptoms are inconsistent, transient, or moving
→ Stress exacerbates your pain
→ You experienced childhood adversity or trauma
→ The triggers for pain or increased pain aren’t related to your physical body
→ You have anxious, hyper-vigilant or perfectionist traits
It is also possible to have none of these signs present and still be experiencing neuroplastic pain. Equally, you might relate to multiple signs and have a physical cause for your pain which has not yet been identified. But the brain and body work closely as one, so there will likely always be a combination of factors when thinking about our pain experience.
How can our emotions impact neuroplastic pain?
When we’re scared our senses are heightened:
Noises appear louder.
Smells seem stronger.
Our skin is more sensitive to touch.
Thinking about the function of fear in our lives (to sense danger and prepare our bodies to take survival-focused action), this makes complete sense. Heightened senses, and greater alertness, mean that we can notice threats more acutely and respond quickly to keep ourselves safe.
It’s perhaps not surprising then, that fear can also heighten our experience of pain. Since pain is a signal to our brain that we are in danger, when we are feeling scared (which in many cases, can be about our pain) any pain signals from our bodies are amplified by our brains.
If your pain is neuroplastic (not the result of structural causes), it likely emerged at a time in your life (or a bit of time following…) when you were going through something big, or perhaps stressful – maybe starting a new job, coping with a bereavement or moving house. Left untreated, neuroplastic pain can become chronic, as pain and fear can be locked in this worsening feedback loop:
Pain triggers feelings of fear → The fear puts the brain on high alert, which causes more pain → Which leads to more fear → Which leads to more pain
You might identify with the word ‘fear’ in relation to pain straight away. Or you might still be having this experience … but not calling it ‘fear’. Perhaps instead, you relate to feelings of frustration, despair, stress, anxiety, or even annoyance. Whilst the labels are different, the impact remains the same. All of these emotions can push us into a state of heightened alertness which exacerbates the pain signals that our brain receives. This ultimately worsens our experience of pain.
Experiencing Pain?
If you’re experiencing pain, aches, stiffness, or soreness with no obvious physical cause, try asking yourself:
- How else were you feeling at the time the pain started?
- Are you going through any significant life events? Or perhaps you’ve just been through one?
- Are you taking care of yourself in other ways (e.g. quality sleep, nutritious eating, social and emotional batteries filled up)?
The answers to these questions can reveal the extent to which your pain experience might be neuroplastic. If this is the case for you, it is be possible to lessen, or remove your symptoms with holistic psychological support, amongst other non-medical interventions. Gordon has developed a treatment called Pain Reprocessing Therapy to address the ‘unlearning’ of neuroplastic pain. At Healthy Mind Psychology we specialise in supporting patients who are dealing with chronic pain, helping you to tackle any feelings and emotions that might be contributing to your pain experience – please get in touch to find out more.
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