Chronic Pain – Rewiring the Brain

The latest developments and research studies in neuroscience are revealing significant discoveries about pain. They are showing that chronic pain changes both the structure and function of our brain and nervous system.

It is no longer just about the body with the saying “no brain, no pain” never being more accurate.

Anatomy 101 – Throughout the body there are nerve endings that convey information up to your brain. The amount of nerve endings in a part of your body determines how much information is delivered to your brain.

How Chronic Pain Rewires the Brain
Chronic pain, over time, can cause changes in the way the brain is wired. Every time you feel pain the same pathways are stimulated in the brain. As a result, this pathway becomes more embedded in the brain. These changes are observable in the homunculus. The brain signals more neurons to “pay attention” to the painful stimulus. This is the beginning of an over-sensitised nervous system often termed, central sensitization.

3 approaches that can help!

  1. Cognitive Behavioural Therapy- CBT

CBT helps to identify and develop skills to change negative thoughts and behaviours. These tools can assist people in creating their own experiences and by changing their negative thoughts and behaviours. These strategies involve changing the awareness of pain and allow the development of better coping skills.

  1. Graded Motor Imagery- GMI

This involves using imagined movement and mirror-imagery to develop neuroplastic changes in the brain. This should be combined with exercise and movement of joints. One of the many ways this works is by decreasing fear associated with movement.

  1. Pain Education.

As previously discussed, chronic pain is often less about what is happening in the body and more about what is occurring in the brain. Learning about pain is proven to alleviate it. Depending on the circumstance, when you understand that if it is not about the body sending signals – then you can start to make the connection that often times it doesn’t mean you are damaged. Here is a great video to watch to better understand this concept created by Professor Lorimer Moseley –


In this process it is also important to incorporate active management, rather than passive coping strategies.

  • Active management– ways to influence pain or to function despite pain – Exercise, activity pacing or support groups.
  • Passive coping – withdrawing and surrendering control to your pain eg. medication, surgery, or injections.

As with any condition, treatment for Chronic Pain should be comprehensive and specific to each case. If you would like more information on managing your chronic pain contact Absolute Balance by mail or view our website

Michael Buswell (B.Sc. – Exercise Physiology)

Senior Accredited Exercise Physiologist (AEP) (ESSAM)


Crofford LJ. Chronic Pain: Where the Body Meets the Brain. Trans Am Clin Climatol Assoc. 2015;126:167-183.

Ahmad AH, Abdul Aziz CB. The brain in pain. Malays J Med Sci. 2014;21(Spec Issue):46-54.