Your brain can decide for you that you should feel pain even if it only thinks there is a potential threat of tissue damage. This means that even if you have no actual tissue damage you can still experience pain.
Even with tissue damage, your brain may not create the feeling of pain
The Paradox of Pain
It means that the pain you feel does not always reflect the severity or even the location of your problem – if there is a problem at all. Science has shown beyond a doubt that pain is created in the brain. Our brains create for us the experience of pain to let us know that something is not ok.
For some people pain can persist even after an initial injury has healed. For these people the pain has become non-informative and non-helpful. The pain itself has then become a problem. The brain has learnt to be in pain. The way the brain does this is very similar to the way the brain learns anything else. It’s called neural plasticity – or brain adaptations.
Did you know that pain is created in your brain?
Did you know that scientists now know that the feeling of pain is something your brain decides that you should experience – if it believes that there is a problem? 1 Your brain can decide for you that you should feel pain even if it only thinks there is a potential threat of tissue damage.2-5 This means that even if you have no actual tissue damage you can still experience pain.6
We also know from scientific studies that even when there is true tissue damage, your brain may not create the feeling of pain for you! 7 8
This is called the paradox of pain. It means that the pain you feel does not always reflect the severity or even the location of your problem – if there is a problem at all. Science has shown beyond a doubt that pain is created in the brain.2 4 9 10
Sometimes pain can be very helpful and informative.1 Our brains create for us the experience of pain to let us know that something is not ok.1 Maybe we are over exerting ourselves, or repetitively bending into awkward postures, causing harm to the body. Maybe we have had an injury that we need to be careful with to allow the body to heal and to avoid further damage. The pain can let us know what not to do while the body heals the problem.1 This pain is helpful and informative. If we listen to our bodies these pain experiences are a good thing.1
But for some people pain can persist even after the initial injury has healed.7 And for some people the pain can spread to other areas where there is no injury at all. For these people the pain has become non-informative and non-helpful. The pain itself has then become a problem. The brain has learnt to be in pain.9 11 12
The way the brain does this is very similar to the way the brain learns anything else. It’s called neural plasticity – or brain adaptations. Did you know that what you focus on actually drives neural plasticity?13-15 This is obviously good if you are focusing on learning something because it will help you to learn it. But if you are focusing on your pain this may actually make your pain worse or persist and harder to get rid of. It is therefore best to focus on the good things. Focus on what is working well. Focus on what makes you happy. Focus on what you are grateful for. This alone can help you heal.1
We know that chiropractic care can help some people with things like back pain,16-19 neck pain20-22 and some types of headaches.23-25 Brain scientists who have studied the effects of chiropractic spinal adjustments have discovered that adjustments also change brain function.26 Chiropractic has a neuroplastic effect on the brain.26 Therefore, it’s possible that you feel better after seeing a chiropractor because changes have occurred in the way your brain interprets your body which impacts how much pain you experience.27 28 In particular adjustments change function in a part of the brain called the pre-frontal cortex.29 The pre-frontal cortex is actually a part of your brain that’s very involved in where pain becomes chronic.30 31 Regardless, neuroscientist believe that chiropractic care most likely helps reduce your feeling of pain by enabling your brain to ‘turn down’ or ‘switch off’ the perception of pain in the brain.26
This means chiropractors may or may not adjust your spine exactly where you feel that it hurts. They are looking for parts of your spine and body where there is a lack of proper movement and will adjust you there26 – so don’t worry if it’s not exactly where you feel the pain is. Remember that the feeling of pain that you experience is created by your brain and does not mean it’s where the problem actually is.
Chiropractors are very good at finding the parts of your spine and body that need to be gently adjusted.33 Research studies have shown that adjusting your spine helps your brain know more accurately what is going on in your body,26 so that it can more appropriately respond to what is going on and control your body better.26 It improves your brain-body communication.26
For more information, go see your family chiropractor so you can sort the pain in your brain.
- Seymour B. Pain: A Precision Signal for Reinforcement Learning and Control. Neuron 2019;101(6):1029-41. doi: 10.1016/j.neuron.2019.01.055 [published Online First: 2019/03/22]
- Koyama T, McHaffie JG, Laurienti PJ, et al. The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Sciences 2005;102(36):12950-55. doi: 10.1073/pnas.0408576102
- Hadjistavropoulos TD, S; Goubert, L.; Mogil J.S.; Sullivan, M.J.L.; Vervoort, T.; Craig K.D.; Cano, A.; Jackson, P.L.; Rainville, P.; Williams, A.C.; Fitzgerald, T.D. A Biopsychosocial formulation of pain communication. Psychological Bulletin 2011;137(6):910- 39. doi: 10.1037/a0023876
- Wager TD. Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain. Science 2004;303(5661):1162-67. doi: 10.1126/science.1093065
- Ploghaus A. Dissociating Pain from Its Anticipation in the Human Brain. Science 1999;284(5422):1979-81. doi: 10.1126/science.284.5422.1979
- Curatolo M, Arendt-Nielsen L, Petersen-Felix S. Central Hypersensitivity in Chronic Pain: Mechanisms and Clinical Implications. Physical Medicine and Rehabilitation Clinics of North America 2006;17(2):287-302. doi: 10.1016/j.pmr.2005.12.010
- Fenton BW, Shih E, Zolton J. The neurobiology of pain perception in normal and persistent pain. Pain management 2015;5(4):297-317. doi: 10.2217/pmt.15.27 [published Online First: 2015/06/20]
- Mitsi V, Zachariou V. Modulation of pain, nociception, and analgesia by the brain reward center. Neuroscience 2016;338:81-92. doi: 10.1016/j.neuroscience.2016.05.017
- Apkarian AV, Hashmi JA, Baliki MN. Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. Pain 2011;152(3 Suppl):S49.
- Atlas LY, Bolger N, Lindquist MA, et al. Brain Mediators of Predictive Cue Effects on Perceived Pain. 2010;30(39):12964-77. doi: 10.1523/jneurosci.0057-10.2010
- May A. Chronic pain may change the structure of the brain. PAIN® 2008;137(1):7-15. doi: https://doi.org/10.1016/j.pain.2008.02.034
- Costigan M, Scholz J, Woolf CJ. Neuropathic Pain: A Maladaptive Response of the Nervous System to Damage. Annual Review of Neuroscience 2009;32(1):1-32. doi: 10.1146/annurev.neuro.051508.135531
- Draganski B, Gaser C, Busch V, et al. Changes in grey matter induced by training. Nature 2004;427(6972):311-12. doi: 10.1038/427311a
- Kolb B, Whishaw IQ. BRAIN PLASTICITY AND BEHAVIOR. Annual Review of Psychology 1998;49(1):43-64. doi: 10.1146/annurev.psych.49.1.43
- Ungerleider L. Imaging Brain Plasticity during Motor Skill Learning. 2002;78(3):553-64. doi: 10.1006/nlme.2002.4091
- Ruddock JK, Sallis H, Ness A, et al. Spinal manipulation vs sham manipulation for nonspecific low back pain: a systematic review and meta-analysis. Journal of chiropractic medicine 2016;15(3):165-83.
- Goertz C, Pohlman K, Vining R, et al. Patient-centered outcomes of high-velocity, low-amplitude spinal manipulation for low back pain: a systematic review. Journal of Electromyography and Kinesiology 2012;22(5):670-91.
- Hidalgo B, Detrembleur C, Hall T, et al. The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews. Journal of Manual & Manipulative Therapy 2014;22(2):59-74.
- Paige NM, Miake-Lye IM, Booth MS, et al. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: systematic review and meta-analysis. Jama 2017;317(14):1451-60.
- Bryans R, Decina P, Descarreaux M, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. Journal of manipulative and physiological therapeutics 2014;37(1):42-63.
- Wong JJ, Shearer HM, Mior S, et al. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. The Spine Journal 2016;16(12):1598-630.
- Gross A, Miller J, D’Sylva J, et al. Manipulation or mobilisation for neck pain: a Cochrane Review. Manual therapy 2010;15(4):315-33.
- Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of manipulative and physiological therapeutics 2011;34(5):274-89.
- Rist PM, Hernandez A, Bernstein C, et al. The impact of spinal manipulation on migraine pain and disability: a systematic review and meta‐analysis. Headache: The Journal of Head and Face Pain 2019;59(4):532-42.
- Fernandez M, Moore C, Tan J, et al. Spinal manipulation for the management of cervicogenic headache: A systematic review and meta‐analysis. European Journal of Pain 2020;24(9):1687-702.
- Haavik H, Kumari N, Holt K, et al. The contemporary model of vertebral column joint dysfunction and impact of high-velocity, low-amplitude controlled vertebral thrusts on neuromuscular function. European Journal of Applied Physiology 2021:1-46.
- Haavik H, Murphy B. The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. J Electromyogr Kinesiol 2012;22(5):768-76. doi: 10.1016/j.jelekin.2012.02.012 [published Online First: 2012/04/10]
- Lelic D, Niazi IK, Holt K, et al. Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study. Neural Plast 2016;2016:3704964. doi: 10.1155/2016/3704964
- Lelic D, Niazi IK, Holt K, et al. Manipulation of dysfunctional spinal joints affects sensorimotor integration in the prefrontal cortex: a brain source localization study. Neural plasticity 2016;2016
- Topham L, Gregoire S, Kang H, et al. The transition from acute to chronic pain: dynamic epigenetic reprogramming of the mouse prefrontal cortex up to 1 year after nerve injury. Pain 2020;161(10):2394-409. doi: 10.1097/j.pain.0000000000001917 [published Online First: 2020/05/20]
- Apkarian AV, Baliki MN, Farmer MA. Predicting transition to chronic pain. Curr Opin Neurol 2013;26(4):360-7. doi: 10.1097/WCO.0b013e32836336ad [published Online First: 2013/07/05]
- Eklund A, Jensen I, Lohela-Karlsson M, et al. The Nordic Maintenance Care program: Effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain—A pragmatic randomized controlled trial. PLoS One 2018;13(9):e0203029.
- Holt K, Russell D, Cooperstein R, et al. Interexaminer reliability of a multidimensional battery of tests used to assess for vertebral subluxations. Chiropr J Aust 2018;46(1):101-17.