Understanding Your Pain

You're here because pain and symptoms have been limiting your life. You've probably seen multiple doctors, tried physical therapy, maybe had injections or even surgery.

You've heard diagnostic terms like degenerative disc disease, fibromyalgia, cervical stenosis, or "idiopathic" something-or-other (which basically means "we don't know").

And despite all that effort and expense, you're still hurting.

I know this story because I lived it for years. But here's what changed everything for me, and what might change everything for you: understanding what pain actually is and how your brain creates it.

This isn't going to be a dry science lesson, I promise. But understanding the basics of how pain works is the first step toward getting your life back. So please read on....

What Is Pain, Really?

But here's where things get interesting: your brain doesn't always wait for actual damage to create pain.

Here's an adventurous hypothetical situation to consider...

Imagine yourself being chased by a lion across an African Savannah. If you sprained your ankle while escaping that lion, you likely wouldn't feel the pain until you reached safety. Your brain had bigger priorities, like keeping you alive.

This demonstrates something crucial: your brain has enormous control over whether and how much you experience pain.

If your brain can turn pain OFF in the presence of injury, it can also turn pain ON in the absence of damage.

At its most basic level, pain is your body's alarm system.

Touch a hot stove? Your hand jerks back before you even think about it. Come down with the flu? Your body aches and you feel feverish. These are signals telling you to rest. Break a bone? That sharp pain tells you to stop using that body part and get help.

This is your central nervous system (brain and spinal cord) and peripheral nervous system (sensory and motor nerves) working together beautifully. Pain receptors throughout your body (called nociceptors) detect potential danger and send signals racing up through your spinal cord to your brain. Your brain's pain circuitry activates, and you feel that unpleasant sensation in a specific spot.

Pain, in this context, is helpful. Critical, even. It's your body's way of protecting you.

When Pain Becomes Chronic

Acute pain (the kind that comes from touching a hot stove or breaking a bone) is time-bound. The injury heals, and the pain goes away. You get back to normal life.

But sometimes pain doesn't go away. It sticks around for weeks, months, even years. That's when pain becomes chronic.

Now, there are certainly conditions where chronic pain makes sense. Cancer, multiple sclerosis, and other diseases that cause ongoing damage to the body can understandably create persistent pain.

But what about all the other cases? The back pain that won't quit even though your MRI looks fine. The migraines that come and go with no clear pattern. The fibromyalgia that doctors can't quite explain.

This is where things get fascinating, AND hopeful.

Your Brain is Much More Powerful Than You Think

Here's a fact that’s widely overlooked: all pain is experienced in the brain.

Not in your back. Not in your shoulder. Not in your knee. In your brain.

Consider phantom limb pain. People experience severe, real pain in a limb that's been amputated. The body part is gone, but the pain is very real.

Or this amazing case from the British Medical Journal: A construction worker stepped on a 15-centimeter nail that went straight through his boot. He was in agony. That is, until they removed the boot and discovered the nail had miraculously passed between his toes without causing any damage.

No injury, but the pain was very real.

Pain, it turns out, is way more complicated than "something is damaged, therefore it hurts."

Alan Gordon, founder and director of the Pain Psychology Center and author of The Way Out, points to thousands of brain scan studies from the last decade that revealed two major insights:

Chronic pain is completely different from acute pain, and
There are multiple brain centers responsible for processing pain (Dartmouth neuroscience professor Tor Wager has identified 44 of them!)

Your pain isn't just about damaged tissues. It's about what your brain is doing with the information it receives, or thinks it's receiving.

When the Alarm System Goes Haywire

Remember, pain exists to protect us. It's an alarm that prevents us from causing further damage when something goes wrong.

But sometimes, the alarm itself goes wrong.

This is where neuroplasticity comes in. Neuroplasticity refers to your brain's ability to continue growing and changing throughout your life based on your experiences.

It's what allows you to learn new skills: walking as a toddler, playing guitar, throwing a baseball. Repeated practice causes neurons to fire together, creating neural pathways. The more those neurons fire, the stronger the connections grow, until the skill becomes automatic.

Here's the thing: your brain can also learn pain.

With enough "practice," your brain can get really, really good at creating pain. Even when there's no threat. This is called neuroplastic pain.

Gordon references a fascinating study of people who'd recently injured their backs. At first, fMRI imaging showed their pain appearing in "normal" pain regions of the brain. But when the pain became chronic, it shifted to parts of the brain associated with learning and memory.

The injury had healed. But the brain had gotten so good at creating pain that it kept doing it anyway.

Neuroplasticity is the quality of our brains that enables us to learn new skills throughout our lives, but it can also cause the brain to "learn" pain in the absence of damage.

Dr. Sarno &

The Mind-Body Connection

One of the first doctors to recognize and work specifically with neuroplastic pain was Dr. John Sarno at NYU School of Medicine.

Back in the 1970s, Dr. Sarno started treating patients who had chronic pain but no underlying structural damage or disease. He developed a theory: their symptoms were being caused by repressed emotions (especially anger and rage) that were so difficult to acknowledge that the unconscious brain created physical symptoms as a distraction.

He called this Tension Myositis Syndrome (TMS), and today it’s also referred to as neuroplastic pain, mind-body syndrome, and other descriptive terms.

Dr. Sarno's approach was entirely psychological. Patients attended his lectures, learned about the emotional roots of their pain, and then (here's the key part) resumed all physical activities with the understanding that nothing was physically wrong with them.

Over four decades, Dr. Sarno estimated he helped about 10,000 patients eliminate their chronic symptoms. Notable names include Howard Stern, Larry David, and Jimmy Kimmel (if you're curious).

How We Understand Neuroplastic Symptoms Today

Today's pain researchers and Mind-Body Syndrome practitioners have expanded on Dr. Sarno's foundational work. We now recognize multiple mechanisms that can create and maintain neuroplastic pain.

Fear is one of the biggest culprits.

Here's how it works: You wake up with a sore shoulder. You start to worry.
That fear activates your brain's fight-or-flight response, which increases muscle tension and releases chemicals that amplify both the pain and your sensitivity
to it.

Now your shoulder feels even worse. The increased pain leads to more fear, which creates more pain, and around and around you go, in what we call the pain-fear cycle.

Conditioning plays a big role too.

Maybe you've noticed your symptoms are worse when it's rainy. Or when you're around a “difficult” person. Or when you sit in a specific chair.

Your brain learns to associate pain with these circumstances and delivers that pain automatically. Even though the circumstances themselves aren't physically harmful.

Adverse childhood experiences (ACEs) like divorce, abuse, or household dysfunction are also common in people with Mind-Body Syndrome.

And certain personality traits are prevalent in folks dealing with neuroplastic pain. Things like perfectionism, low self-esteem, and people-pleasing. Dr. Sarno called this the "Type T" personality.

But Wait, Something Really IS Wrong with Me!

I get it. You might be thinking, "This sounds like you're saying my pain is all in my head."

Let me be crystal clear: Your pain is real. Neuroplastic pain is genuine physical pain. It just happens to be created by your brain rather than by damaged tissues. In fact, Dr. Sarno used to remark that people with neuroplastic symptoms often experienced more intense symptoms than those with structural damage.

And honestly, we experience physical responses to emotions all the time. You blush when you're embarrassed. Your stomach does somersaults when you're nervous. Tears stream down your face when you're sad.

Why would pain be any different?

And My MRI Shows Real Damage!

Maybe you've had imaging done. An X-ray, MRI, or CT scan that showed arthritis, disc degeneration, a torn meniscus, or something else that sounds alarming.

Modern imaging is incredibly valuable for diagnosing serious conditions. But here's what most doctors don't tell you: it's actually a pretty poor predictor of what will cause pain in most people.

Check out this data from a 2021 study that looked at imaging results from people with zero symptoms:

• Back: 52% of people in their 30s have disc degeneration; 96% of people in their 80s

• Neck: 87% have bulging discs

• Shoulder: 72% have superior labral tears

• Hip: 69% of adults (89% of athletes) have labral tears

• Knee: 97% show "abnormalities"

• Ankle/Foot: 63% have Achilles tendon changes; 68% of runners have retrocalcaneal
changes

These findings are often called "normal abnormalities." We all have some degree of wear and tear in our bodies. But most of the time, it's not causing pain.

The real question isn't "What does my imaging show?" It's "What's making my brain interpret normal sensations as dangerous?"

Diagnosis Isn't Destiny

I know how scary medical diagnoses can sound. Terms like "degenerative," "stenosis," "syndrome," or "chronic" can make you feel like your body is broken beyond repair and your only options are medication, surgery, avoiding activities, or just living with it.

And to make things worse, your brain can cling to these messages and amplify your symptoms in response.

But what your brain has learned, it can also unlearn.

Here's a partial list of conditions that respond well to a mind-body approach. Note that many of these aren't even pain-related. This is further evidence of the powerful connection between our thoughts, emotions, and physical symptoms:

• Migraine and tension headaches
• Irritable Bowel Syndrome (IBS)
• Neck, back, and shoulder pain
• Fibromyalgia
• Pelvic pain syndromes (coccydynia, interstitial cystitis, chronic prostatitis)
• Heartburn/acid reflux
• Carpal tunnel syndrome
• Chronic fatigue syndrome
• Tinnitus
• Numbness or tingling sensations
• Complex Regional Pain Syndrome (CRPS)
• And many more

Important note: It's critical to rule out any serious medical conditions before adopting a mind-body approach to your healing. Once you've cleared that hurdle, you're ready to take charge of your own recovery.

So What Does This Mean for You?

If you're thinking, "Okay, this is interesting... but what am I supposed to do with this information?" I hear you.

Understanding that your pain is neuroplastic doesn't make it disappear overnight. But it's the essential first step.

Once you understand that:

Your pain is real, but not caused by damage
Your brain learned these pain patterns
What's been learned can be unlearned
You're not broken, fragile, or doomed

...then real healing becomes possible.

The work involves retraining your brain, addressing the emotions and stressors that keep your nervous system in danger mode, and gradually teaching your body that it's safe again.

It's not always a straight line. (My own recovery certainly wasn't.) But it's absolutely possible, and it starts with understanding what's really going on.

Ready to Take the Next Step?

If this resonates with you (if you're thinking, "Wait, this might actually explain what I've been experiencing"), then let's talk.

Click below to schedule your free 30-minute consultation. We'll explore your specific situation and I'll help you understand whether a mind-body approach makes sense for your symptoms.

Let's Get Started!

You don't have to figure this out alone. And you definitely don't have to live with chronic pain forever.

References:

Gordon, A. The Way Out. Avery Publishing, 2021.

Schubiner, H. Unlearn Your Pain: A 28-Day Process to Reprogram Your Brain (4th Edition). Mind Body Publishing, 2022.

Sajid IM, Parkunan A, Frost K. "Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care." BMJ Open Quality 2021;10(3).