Imagine a life without chronic pain. For many, this dream feels out of reach, but recent breakthroughs suggest it might be closer than we think.
An estimated 20% of the global population endures chronic pain – a condition persisting for three months or longer. In the UK, this condition is alarmingly prevalent, affecting between one-third and one-half of the population.
Pain manifests in three main forms:
- Nociceptive. Arising from tissue injury or inflammation.
- Neuropathic. Resulting from nerve damage.
- Nociplastic. Stemming from a sensitised nervous system, without an evident physical cause, indicative of abnormal signal processing within the body.
The first two types of pain are like the brain’s alarm system, signalling injury and prompting actions to avoid further harm. But nociplastic pain is different. It’s as if the brain’s alarm gets stuck on high alert, causing pain even when there’s no injury. This type of pain is often linked to chronic conditions like fibromyalgia, nonspecific chronic low back pain, headaches, and irritable bowel syndrome, among others.
Pain is essentially a warning sign from the brain, but sometimes it can persist without any real danger. Alan Gordon calls this “neuroplastic pain” highlighting how changes in the brain’s neural pathways can keep the pain signal going.
Why does the brain generate pain in absence of injury?
The biopsychosocial model of pain illustrates that physical symptoms arise from a complex interplay of biological, psychological, and social factors. While it’s well-known that pain can lead to psychological distress, it’s equally important to recognise that these issues can, in turn, exacerbate – and, crucially, even create – the experience of pain. Indeed, psychological factors like depression, anxiety, low self-efficacy and fear avoidance increase the risk for people who suffer with chronic pain.
For instance, fear avoidance involves avoiding activities that might cause pain. When we experience pain for a certain period of time, the neural pathways of pain in the brain become strengthened. The fear of pain leads to reduced participation in daily life, as individuals anticipate that engaging in these activities will worsen their pain. Consequently, they might stop exercising, socialising, or even performing basic tasks, further diminishing their quality of life and, crucially, reinforcing the internal message to the brain that the pain is actually dangerous (that is, caused by actual damage).
Anxiety, stress, and traumatic experiences can all trigger a hypervigilant state of mind. When our nervous system is on high alert, the brain tends to interpret both external and internal signals as threats. For instance, a noise from upstairs or a shadow glimpsed from the corner of our eye can startle us. Similarly, bodily sensations are more likely to be perceived as painful, even in the absence of tissue injury or inflammation.
It is crucial to recognise that, even though this type of pain originates in the brain and is related to how neural pathways process signals, it is still genuine pain. The fact that it arises from the brain’s interpretation rather than a direct physical injury does not make it any less real. The experience of this pain is just as intense and impactful, influencing daily life significantly. It deserves to be recognised and treated with the same seriousness as pain from identifiable physical causes.
Treating brain-generated pain
A 2022 study examined the effectiveness of (tele)rehabilitation for individuals with chronic musculoskeletal pain. It found that behavioural modification techniques (BMT) such as acceptance and commitment therapy (ACT), cognitive behavioural therapy (CBT), education, self-management, exercise, exposure therapy, and mindfulness are generally effective in reducing pain-related fear of movement and decreasing the overall impact of the condition. But he evidence is mixed regarding their effects on pain intensity, psychological distress, and symptoms of anxiety and depression.
That isn’t surprising, if we refer to the above-described concept that connects the experience of pain to a nervous system perpetually in high alert. The key to alleviating chronic pain lies in helping the brain to exit its hypervigilant state of threat, as demonstrated by pain reprocessing therapy (PRT), which uses a set of techniques aimed at breaking the pain-fear cycle.
The pivotal concept is that as levels of fear and stress decrease, the brain is more likely to interpret signals from the body as safe, leading to a reduction in pain.
So, nociplastic/neuroplastic pain sufferers need to effectively lower their nervous system’s stress response by: resolving anxiety, addressing past trauma, processing grief, manage potentially threatening emotions such as destructive anger, and more.
Easier said by done, you may think!
Enter BrainWorking Recursive Therapy which does just that – and it is incredibly fast
Created by Terence Watts, BWRT is a new, body-mind based therapy that uses natural psychological processes to recondition neural pathways in the brain that lead to unwanted behaviour, thoughts or nervous system responses.
This groundbreaking therapy, based on neuroscience discoveries about the way the brain works and how it affects our moods, behaviour and emotions, provides an entirely natural way to “rewire” our thoughts and emotional reactions.
One of its many positive qualities is that we do not have to divulge anything we would rather not talk about – in fact, the therapist will only need to know how we feel and how we would prefer to feel instead.
It is extremely effective at dealing with all sorts of Anxiety related issues, Past Trauma, GAD, Social Phobia, Panic Attacks, PTSD, Low Self Esteem, Confidence and many other psychological difficulties because it stops troublesome, anxious, irrational thoughts before you are even aware of them.
Because BWRT can create rapid and permanent change in how the neural pathways work, without the need for any ongoing coping strategies, the nervous system will quickly respond to the decrease in levels of fear and stress, and the brain will re-learn to interpret signals from the body as safe, leading to a quicker and more permanent reduction in pain.
Annalisa Manca, PhD is an integrative psychotherapist and registered advanced BWRT Practitioner trained in somatic, psychodynamic and pain reprocessing therapies. Annalisa specialises in trauma healing, anxiety, and nervous system regulation, grounded in neuroscience, neuroplasticity, and polyvagal theory.
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