Chronic Pain Explained: Break the Cycle & Regain Control
Chronic pain lives in your brain long after injury heals. Learn the hidden mechanisms behind it — and how to retrain your nervous system to ease pain and restore freedom.
Understanding Chronic Pain
Chronic pain can be mild or excruciating, it can be episodic or continuous, it can be merely inconvenient or totally incapacitating. The pain can be from headaches, or joint pain, it can be neck pain, back pain or pain from an injury.
The common thing with all these types of pain is that the actual feeling of pain is always, 100% of the time, created in your brain.
Neuroscience Research
Did you know that imagining a movement influences the brain in a very similar way to actually doing the movement? This can help to retrain your brain to understand that the movement is not dangerous – because imagining doing the movement will not hurt. You can basically trick your brain into giving you back pain-free movement.
Movement and Function
The movement of your spine is also very important. Yoga or simple spinal exercises can be great for this and chiropractic care may be really important to help you move too. The main focus of chiropractic care is to improve the movement and function of your spine.
What is Chronic Pain?
Experiencing pain is normal. Everyone experiences pain now and then.1 Pain is supposed to be protective to make you stop doing things that may be dangerous.2 But chronic pain that has persisted for more than 3 months is no longer protective, nor informative.3
So, what is chronic pain and what can you do about it if you suffer from it?
All pain is created by your brain because your brain has decided that you are threatened and in danger and need protecting.4-9 The interesting thing is that you don’t actually have to have any actual tissue damage to feel pain.10 And if your brain is not aware of tissue damage, you may not feel any pain at all, even if you’ve injured yourself.4 6
Sometimes pain persists long after tissue damage has actually healed.11 When pain persists for more than 3 months we call this chronic pain. Chronic pain is the second-most common reason people see a doctor and miss work.11 More than one-third of people with chronic pain become disabled by their pain to some degree.12 13
Your pain experience depends on why your brain has decided you need to be protected.
Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating. The pain can be from headaches, joint pain, neck pain, back pain or pain from an injury.
Other kinds of chronic pain include:
- tendinitis
- sinus pain
- carpal tunnel syndrome
- pain affecting specific parts of your body
The common thing with all these types of pain is that the actual feeling of pain is always, 100% of the time, created in your brain.5 8 14 15 This does not mean it’s not real – but understanding that the pain itself is created in your brain is really important for how you can get rid of it. And because pain depends so much on what you think and feel about the pain,2 it’s very important you understand pain properly.
Your pain experience depends on why your brain has decided you need to be protected – why it’s creating the feeling of pain for you in the first place.5 It can, therefore, be very useful for you to try to figure out why your brain may be creating pain for you. What was happening at or around the time your pain started. What makes it worse? What makes it better?
Why is that important? Because we know that the brain can be retrained,16 so you need to use all the tools available to you to retrain your brain to be out of pain.16 Some of the keys to retraining your brain are staying active,17-19 staying positive,20 eating well,21 22 and sleeping well.23
Stay Active
One important way that you can help yourself if you are in chronic pain is to stay active.17-19 Your posture and how you move plays an important role in how you feel and how you experience pain.18 19 Even as little as a short walk every day can help.19 If there are movements you cannot do because of your pain you can still help by imagining these movements.24
We know from neuroscience research that imagining a movement influences the brain in a very similar way to actually doing the movement.24 25 This can help retrain your brain to understand that the movement is not dangerous – because imagining doing the movement will not hurt. You can basically trick your brain into giving you back pain-free movement.24 Play with these sorts of things. Make movement fun. Move in different emotional states, like when you are happy or grateful. Move outside – in the sun, in a park with beautiful plants and flowers. Move in the water.
The movement of your spine is also very important.26 Yoga or simple spinal exercises can be great for this and chiropractic care may be really important to help you move too.27-29 The main focus of chiropractic care is to improve the movement and function of your spine.30-32 This is so important because proper movement of your spine helps your brain know more accurately what is going on, not only just in your spine, but also elsewhere in your body.33 34 And research tells us that chiropractic care can help people who suffer from back pain,38 39 and headaches.40 This is most likely because chiropractic care helps your brain know more accurately what is going on in your spine and body33 41 and may help your brain to switch off feelings of pain, when they are no longer needed. So if you suffer from chronic pain do your best to stay positive,20 move often,18 19 eat well,21 22 sleep well,23 and go see your family chiropractor to help retrain your brain to be out of pain.38 39
Pain is Created in Your Brain
Your brain can decide for you that you should feel pain if it 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.
Neural Plasticity
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.
The Feeling of Pain
Did you know that scientists now know the feeling of pain is something your brain decides you should experience if it believes there is some tissue damage in your body? 1 In fact, your brain can decide that you should feel pain even if it only thinks there is a potential threat of damage! 2-5
It may seem strange, but it’s totally up to your brain to decide whether you should feel pain or not. Your brain may decide you should experience pain even if you have no actual tissue damage yet,6 or your brain may not create the feeling of pain for you when tissue damage has actually occurred! 7 8
This is called the “pain paradox”. 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 your brain! 2 4 9 10
Sometimes pain can be very helpful and informative.1 Our brains create the experience of pain to let us know something is not ok.1 Maybe we are overexerting ourselves, or maybe we have had an injury that we need to be careful with to allow our body to heal. The pain can let us know what not to do while our body heals the problem.1 This pain is helpful and informative.1
If we listen to our body these pain experiences can be a good thing. But for some people, pain can persist even after the initial injury that caused it has healed.9 11 12 And for some people, the pain can spread to other areas that are not injured at all.6 For these people, the pain has become non-informative and non-helpful.9 11 12 The pain itself has 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. It’s called neural plasticity – or brain adaptations.9 11 12 Brain scientists now know that what you focus on drives the way your brain will change.13-15 This can be a problem if you are focusing on your pain because it may make your pain worse. So, even if you’re in pain, try to focus on the good things in your life instead of your pain. Focus on what is working well. Focus on what makes you happy. This alone can help you!1
Brain scientists who have studied the effects of chiropractic spinal adjustments, have discovered that adjustments may change brain function.16
Chiropractic has a neuroplastic effect on the brain.16 In particular, adjustments change function in a part of your brain called the pre-frontal cortex.17 This part of your brain is actually the part of your brain that’s very involved in pain becoming chronic.8 18-21 This might be why getting chiropractic care early on when you have a problem has better long-term outcomes.22 It might also be that chiropractic care can prevent pain from becoming chronic.22
Neuroscientists believe that chiropractic care most likely helps reduce your feeling of pain by helping your brain ‘turn down’ or ‘switch off ’ the perception of pain in your brain.23 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/or body where there is a lack of proper movement and they will adjust you there – so don’t worry if it’s not where you feel the pain.
Pain is our Alarm System
When some of the parts of your brain get particular messages in a specific pattern, the brain decides for you to make you feel pain to warn you that something might not be right, that you may be in danger.
Chiropractic helps your brain know what is going on in the spine and body
Sympathetic and parasympathetic system
When your alert and danger (sympathetic) system is really active your heart beats faster, your brain mobilizes your bodies energy stores and you become more alert and vigilant and you even sweat more. When the alert and danger (sympathetic) system is more settled your calm & healing (parasympathetic) system takes over. This allows your brain and body to calm down, to heal tissue cells and to digest your food properly.
Prefrontal Cortex
Scientists have shown that chiropractic care changes the function in your prefrontal cortex – one of the brains orchestra conductors. This is also probably why chiropractic care helps people who are suffering with pain – by changing the pain music in the brain itself.
Break the Pain Cycle
For some people, pain can become a real problem, because it can persist even after an initial injury has healed. When this happens, we call it chronic pain. When you have chronic pain, your brain has learned to be in pain and you have entered a nasty pain cycle.
When you have chronic pain, your brain has learned to be in pain
The Prefrontal Cortex
The pre-frontal cortex is actually the part of your brain that is very involved in how we end up in this vicious chronic pain cycle. Research studies have shown that chiropractic care may ‘reset’ the way the brain processes pain information so that it does not learn to be in chronic pain.
Who sees a Chiropractor?
More and more people will see a chiropractor, but you may be surprised to know exactly why chiropractic care is becoming so much more popular. A recent study found that about 1 in 4 Americans have visited a chiropractor, and almost 20 million Americans see a chiropractor each year.
Chiropractic care helps improve your health and well-being
Why Chiropractic Care?
Although back and neck pain was the main specific health problem people gave for seeing a chiropractor, almost half of the chiropractic patients said they went for general wellness or disease prevention.
Benefits of Chiropractic Care
So why do so many people go to see a chiropractor?
It’s not just because they get a lot of help if they suffer from pain and other health problems. They go because they want to perform better on the sporting field or athletics track. They want to sleep better; they want to deal with stress better and to be better able to relax. They go because they want to improve their overall health and function at their best.
How often should you see your chiropractor?
When you first see your chiropractor, you may be among the many people who ask, “how often do I need to come?”. The answer that you may want to hear is once. But chiropractic care, like most things that are really good for us, rarely makes a long-term difference to your health and wellness after just one visit.
Seeing your chiropractor can be a little like going to the gym. It takes time, frequency and follow up to retrain the spine to function well.
Maintenance Care
One reason for having to see a chiropractor regularly is because it usually takes years for the problem to develop which motivates someone to first see a chiropractor and it can take many visits to the chiropractor to correct that problem.
Care Plans
When you go and see your chiropractor know that their recommendations for your plan of care are based on what their clinical experience tells them is best for you and that the research suggests more frequent adjustments have the biggest positive impact on your health and wellness.
Visiting a chiropractor
When you first see your chiropractor, you may be among the many people who ask, ‘how often do I need to come?’ Often the answer people want to hear is ‘once’ but chiropractic care, like most things that are really good for us, rarely makes a longterm difference to your health and wellness after just one visit.
One reason a single visit to your chiropractor may not make a long-term change is that it usually takes years for the problem to develop that motivates someone to first see a chiropractor and it can take many visits to the chiropractor to correct that problem.
Seeing your chiropractor can be a little like going to the gym. It takes time, frequency and follow up.
One way of looking at it is that it can be like the thousandth straw that breaks the camel’s back. A problem can build up day after day as you sit hunched over your desk, or bend and twist as you lift, or tense up as you deal with your daily stress and then one day, you bend to tie your shoelaces and all of a sudden something hurts! You can rest assured that tying your shoelaces isn’t what caused the problem, it’s simply the thousandth straw that broke the camel’s back (or was too much for your back) and that’s why you’re in pain.
There will usually be changes to the way the supporting muscles in your spine work that build up over time until your muscles can’t cope anymore and symptoms appear.1-2 So, seeing your chiropractor can be a little like going to the gym. It takes time, frequency, and follow up. Working with you to correct the problem and help your brain and the muscles in your spine communicate or ‘talk’ with each other again so you can regain the stability you need to function properly and resolve your aches and pains.3
But how long will this take and how often do you need to be checked by your chiropractor? Everybody is different, so your chiropractor will be guided by their clinical experience, and what your goals are when they recommend a care plan for you.
US Research Study
A new research study was recently published that suggests, in the early stages of chiropractic care, the more often you get adjusted, the better the results you enjoy, and this can also be better for you in the long term as well.4
In this study, that was conducted by scientists in America, they looked at 256 people who had chronic, regular headaches and divided them into groups who either received chiropractic care once a week, or twice a week, or three times a week, for up to six weeks, or they received no chiropractic care at all and instead were given light massages over the same 6-week period. Previous studies have shown that people with this kind of headache often respond well to chiropractic care.
The scientists in this study were most interested in how many visits per week to the chiropractor showed the best results. They looked at how many days a week a patient suffered from headaches at the end of the study and whether any changes in headache frequency between the groups were still there up to one year later. What they found was that the patients who were seen by their chiropractor most regularly, so up to three times a week, had fewer headaches than those who were seen once or twice a week, and they were much better than the patients who received no chiropractic care at all.
In fact, after one year, the patients that had been seen three times a week had over three fewer headaches per month compared to the patients who only received a light massage. So, these effects obviously lasted.
The more you get adjusted, the better the results that you will enjoy.
This study was done in people with chronic headaches, so we can’t be sure if the same differences occur in people with other problems who see a chiropractor. A similar study in patients with chronic low back pain did find that people who were adjusted more often had the best results, but the results weren’t as clear as the study done on patients with headaches.5
The studies suggest that seeing a chiropractor more often when you begin care has real, beneficial, long-term effects to the way your spine and nervous system works, but how much you benefit may depend on what’s wrong with your spine when you begin care.
So, when you go and see your chiropractor, know that their recommendations for your plan of care are based on what their clinical experience tells them is best for you, and that the research suggests more frequent adjustments has the biggest positive impact on your health and wellness.
