Six Signs Your Chronic Pain Could Be Neuroplastic

Another June has arrived. Ron sits at his desk at 4:30 in the afternoon with a stack of final essay exams that needs his attention, but his mind is elsewhere.

Specifically, on his right shoulder. Since returning from winter break, it’s been barking at him every time he’s at the front of the room, writing something on the board. And at this point in the school year, the pain is traveling up the side of his neck and even down his upper arm.

That pattern has been around for three years now, although last year his lower back was the culprit. Things do tend to ease up during summer break, which is, thankfully, well within sight. His doctors have run out of suggestions, and he’s 99% resigned to the idea that this may just be how the rest of his life looks.

Ron’s situation may feel familiar to you, even if the specific symptoms are a little bit different. If you found yourself nodding your head, empathizing with Ron, his pain, and his frustration, you know all too well what it’s like to be doing all the “right” things about your pain, only to be let down time and again, treatment after treatment.

But the reason Ron, and perhaps you, are having such a hard time isn’t that there’s some sort of structural damage or an infection that’s hiding itself; doctors are usually excellent at identifying those things. What’s happening is that his nervous system is stuck in threat mode, and his brain interprets even the most benign sensations as pain. Similar to a car alarm that goes off even when a falling leaf hits it.

That’s very real, and very different, kind of pain, called neuroplastic pain.

Here are six patterns or signs worth paying attention to if you’re trying to determine whether your symptoms are neuroplastic.

Sign 1: Your pain started after a stressful life event, not a clear injury.

Maybe your pain started with the introduction of a new curriculum. Or the retirement of a beloved colleague. It may even have arrived shortly after a promotion at work or the birth of a new child.

All of these changes, welcome or unwelcome, can elevate stress levels and cause strong emotions to go unprocessed as you push through new and unfamiliar circumstances. The nervous system can be highly sensitive to these changes, and symptoms arising during such periods is a classic neuroplastic pattern.

Sign 2: Your pain has spread or moved around, or new symptoms have appeared over time.

Look at Ron: two years of shoulder and neck pain that bookended a year of lower back pain. Perhaps in your case it started as hip pain, and then you found yourself with digestive issues as well, and then carpal tunnel symptoms.

Structural problems don’t jump from one body part to another. And while it’s natural to assume that each new symptom has its own separate cause, it’s often more likely that the spread and shifts in your symptoms are just the nervous system’s “sensitization map” expanding.

Sign 3: Your symptoms fluctuate with stress, mood, or context in ways that physical damage can’t explain.

Ron’s pain kicked in after the winter break and escalated during a period that, for educators, typically offers little time off. He’s also become familiar with the pattern of symptoms easing up in the summertime.

Do circumstances change your symptoms?

Structural damage doesn’t take time off, but nervous system responses can ebb and flow. Without a doubt, this kind of fluctuation can be perplexing and even scary, especially when you’re in a bad flare-up. But the upside to this fluctuation is that it shows you the pain is responsive to safety signals (summer vacation), which means more lasting change is possible.

Sign 4: Tests and imaging came back normal, or the findings don’t match your level of pain.

Your MRI report might mention “normal age-related changes,” “mild disc degeneration,” or similar findings. Your doctor might even say that everything looks ok, or what they do see doesn’t come close to explaining the severity of your symptoms.

It’s important to remember that studies consistently show a very poor correlation between structural findings and pain levels. So medical phrases like “degeneration” that can sound dire are often just “gray hair of the spine” that almost all people experience, without pain.

At the same time, being told that everything looks fine can be equally alarming because it leaves you in a place of uncertainty, and as a species, we typically crave certainty.

Nevertheless, a normal MRI isn’t a dead end. Instead, it points toward the nervous system.

Sign 5: Your pain flares in anticipation of an activity, not just during or after it.

This is a big one, and it can show up as lower back pain flaring up the night before a long car trip, a migraine appearing the morning of parent-teacher conferences, or shoulder pain that increases right before a tennis date.

In coaching sessions, some people can become symptomatic when they’re simply asked to visualize doing a particular activity.

These are all classic examples of learned responses, not structural or pathological conditions. The good news: what the nervous system has learned, it can unlearn.

Sign 6: You’ve found that conventional treatments provide only temporary relief (if any).

Injections may work for a short stretch before petering out. Physical therapy brings improvement, but symptoms resurface after a couple of weeks. A massage can feel blissful for a day, but the next morning you’re back to square one. Each new treatment offers some promise, but the pattern persists.

Temporary relief followed by a return of symptoms is what can happen when you focus on managing an output (symptoms) without addressing the underlying cause (a sensitized nervous system). If the issue were indeed structural, those treatments would have a lasting impact.

It’s like tinkering with the hardware when the real culprit is the software.

Applying the Right Context to Your Experience

Without the right context, it can be easy to experience these signs as alarming. After all, symptoms that aren’t responding to treatments offered by medical professionals, or that behave in strange ways, like moving from one body part to another, or that lack undeniable evidence from scans or other tests, can suggest something insidious and leave you feeling understandably at a loss for what to do next.

However, the context we can now apply, thanks to ongoing developments in pain neuroscience, suggests something much less dire: symptoms with those characteristics are highly likely to result from a nervous system that is overloaded and misinterpreting signals from the body.

Why is that good news? You don’t need medication, surgery, or other medical interventions to retrain a nervous system that’s stuck in threat mode. Many different techniques can be used to send the brain consistent messages of safety and literally rewire those faulty circuits responsible for your symptoms.

In fact, just reading this article and understanding the principles it lays out is a small step in that direction.

Educators already have many of the characteristics that are important assets in neuroplastic pain recovery, like the ability to observe carefully, being okay with complexity, and a knack for taking in new information and applying it.

Take Another Step, Right Now

One thing you can do almost immediately is to pick one of the six signs that most closely fits your circumstances (and there may be more than one), and get curious about how it showed up for you. For example:

• Can you identify when the pattern started?

• What was happening in your life when it first appeared?

• What activities, events, or circumstances are present when your symptoms escalate or when you feel a little bit better?

• What’s the nature of the self-talk you engage in when you consider these signs?
  

No need to pressure yourself into finding “correct” answers to the questions. Sit with them briefly on a relaxed Sunday morning, or for a few minutes of your prep period, or in that quiet time just before the students arise.

Genuine curiosity is itself a form of safety-messaging to your brain, and it helps you develop an internal terrain that’s conducive to going deeper without increasing fear or anxiety.

If you feel that just a little more guidance and structure would be helpful, my free five-day mini course, One Thing A Day, is the natural next step. A short, accessible practice will be delivered to your inbox each of the five days. It’s designed for people who are starting to think about their symptoms differently and want to take action without feeling overwhelmed. Sign up right here.

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Wishing you good health and quick healing.