Our brains are great at learning useful skills, but the dark side is that they are also great at learning bad habits. Like pain. When the brain experiences pain over and over, those neurons get “wired together,” and they get better and better at firing together. Unfortunately, that means the brain gets better and better at feeling pain. If a brain gets too good at experiencing pain, the condition can become chronic. Basically, your brain can unintentionally learn how to be in pain.
That’s the origin of the term “neuroplastic pain.” “Neuro” refers to the brain and other parts of the nervous system; “plastic” means developed or changed. Neuroplastic pain is when the brain changes in such a way that reinforces chronic pain.
One of the most important pain studies of the last few years actually captured this process in action. Researchers followed people who had recently injured their backs. At first, their pain was active in the normal pain regions of the brain. But when the pain became chronic, it shifted to parts of the brain associated with learning and memory.
Neuroplastic pain is a fundamentally different kind of pain. It’s pain that has gotten stuck because your brain has learned it too well. The good news is that just as your brain can learn pain, it can unlearn it. Pain Reprocessing Therapy retrains your brain to interpret signals from your body properly. Over time, this rewires your brain and deactivates your pain.
Plain Pain or Brain Pain?
Now that you know the difference between normal pain and neuroplastic pain, it raises the question: If you’re in pain, how do you know which one you have? I’ve done many intakes with pain patients, and one of the first things I do is assess whether their symptoms are likely to be neuroplastic or caused by structural problems in the body.
These are some of the questions I ask:
- Have medical treatments been ineffective or just given you temporary relief?
- Did the pain come on during a stressful time in your life?
- Do you have (or have you had) symptoms in multiple parts of your body?
- Is your pain inconsistent in terms of where and when it appears and how severe it is?
- Do you think about the pain often or all the time? Does it worry you throughout the day?
I wish this were like a magazine quiz and I could give you five points for every “yes” answer. But it’s not that simple. There is no definitive checklist. While “yes” answers are associated with neuroplastic pain, we assess everyone on a case- by-case basis.
As I said in chapter 1, neuroplastic chronic pain is more common than structurally caused chronic pain.
How much more common? In the Boulder Back Pain Study, there were fifty subjects in the treatment group. Dr. Howard Schubiner, who specializes in pain, did a medical consultation, and I did a more general evaluation. Based on our initial assessments, as well as evidence we gathered during treatment, we found no cases of chronic back pain that we believed to be structurally caused. None!