All pain is generated by the brain, and most chronic pain does not stem from tissue injury to the body. This might sound dismissive, but we hope to show you a new, hopeful perspective.
Neuroplastic pain is very real, but it originates in the brain’s misinterpretation and misfiring of pain circuits, not in tissue damage. And just as the brain can learn pain, it can also unlearn it.
Acute Versus Chronic Pain in the Brain
PRT observes visible brain changes. The thalamus and anterior cingulate insula are acute pain processing regions. But when pain turns chronic, it becomes associated with the medial prefrontal cortex and the amygdala. These are brain regions related to learning, meaning-making, emotion, and storytelling. These are not brain regions that process input from the body! Once pain shifts to these regions, it can live in a loop relatively independent of input in the body.
Common Signs Your Pain Might Be Neuroplastic
While only a trained provider can offer a true diagnosis, there are some common patterns that suggest your symptoms are brain-generated. In the PRT community, we often use the FIT Criteria to help identify neuroplastic pain:
- Functional — Your pain presentation does not fit with and is not explainable by known structural conditions.
- Inconsistent — Your pain varies in ways that structural pain would not.
- Triggered — Your pain is brought on by stimuli that would not normally cause the symptom physically, but they activate the brain to generate the symptom. This may be due to emotional stress, innocuous stimuli, or triggering thoughts.
If this sounds like your experience, the pain is not “all in your head”, but it may be something your brain has learned and remembered.
But My MRI Shows Something…
You’re not alone. Many people with chronic pain have MRI or X-ray findings that sound scary. But research shows that all kinds of “normal abnormalities” are highly present in pain-free populations:
- 87% of pain-free necks have bulging discs
- 72% of pain-free shoulders have superior labral tears
- 97% of pain-free knees will show some “abnormality” on imaging
In most cases, these are incidental findings. Pain is about perception and context. What your brain believes about the pain will often predict the experience of it, and fear, frustration, and confusion can unfortunately amplify it.
How Can I Know for Sure?
If your pain is influenced by stress, seems to move or shift, or resists physical treatments, there’s a good chance it has a neuroplastic component.
The best way to know is to:
- Talk with a provider trained in mind-body approaches.
- Explore your pain patterns and history through assessment, gathering evidence as you go.
- Try brain-based techniques and notice your response. Does imagining activity alone trigger your pain? If so, this confirms that the brain is creating pain (in the absence of any physical input).
Listen to our podcast episode: Is My Pain Neuroplastic?
A message from our founder: Some patients find comfort in a diagnosis from a doctor, even if it confirms a physical problem. It takes away uncertainty, and living with chronic pain can feel like chronically searching for answers. A neuroplastic diagnosis can understandably feel scary and confusing, but it can also be freeing—because it points to a treatable cause.
What to Do If You Suspect Neuroplastic Pain
You don’t have to figure this out alone. If you’re ready to explore this path:
Join a Healing Workshop
Book a 1-on-1 session with WellBody Psychotherapy
Explore our Glossary of PRT Terms
Find a PRT Practitioner
Final Thought
If you suspect your pain may be neuroplastic, you’re not broken, and you have every ability to heal. Your brain is only trying to protect you. And with the right tools, it can learn a new path forward.
You deserve relief—and recovery is possible!