What Is Neuroplastic Pain? An Easy Guide for Patients and Clinicians

Have you ever wondered why some pain persists long after an injury has healed? Neuroplastic pain, also known as central sensitization or primary pain, explains why this happens and what you can do about it.

Understanding Neuroplastic Pain

Imagine your nervous system as an alarm system designed to protect you from harm. Neuroplastic pain occurs when this alarm system becomes overly sensitive, triggering pain signals even without actual damage or threat. Essentially, your brain starts to overreact, perceiving danger where there is none (Woolf, 2011).

How Is Neuroplastic Pain Different from Other Pain Types?

To understand neuroplastic pain, let’s first distinguish it from other types:

• Nociceptive Pain: The immediate pain you feel from an injury, such as a cut or broken bone.

• Neuropathic Pain: Pain resulting directly from nerve damage, like diabetic neuropathy.

• Neuroplastic Pain: Pain stemming from changes in the brain and nervous system without ongoing physical damage, often influenced by stress, emotions, or learned responses (Moseley & Butler, 2015).

Common Signs You Might Have Neuroplastic Pain

You might have neuroplastic pain if you experience:

• Pain that lasts for more than 3-6 months after the initial injury heals.

• Pain that doctors can't clearly explain or link to specific physical damage.

• Increased sensitivity, feeling pain from gentle touches or normal movements.

• Pain that shifts around the body, involving multiple joints.

• Pain that fluctuates depending on your emotions, stress, or environment.

Why Does Neuroplastic Pain Happen?

Several factors may lead your brain to amplify pain signals:

• Emotional Stress and Trauma: Significant emotional events or trauma can "rewire" your nervous system, making it hypersensitive (Lumley et al., 2011).

• Learned Pain Responses: Your brain may begin anticipating pain, reinforcing pain signals even without actual injury (Harvie et al., 2015).

• Fear and Anxiety: Negative emotions can heighten your nervous system's sensitivity, intensifying your experience of pain (Leeuw et al., 2007).

How to Diagnose Neuroplastic Pain

Diagnosis typically involves:

• Reviewing your detailed medical history.

• Conducting thorough physical exams and medical imaging to rule out structural issues.

• Recognizing symptoms consistent with heightened nervous system sensitivity, such as widespread pain or emotional triggers (Nijs et al., 2021).

Effective Ways to Treat Neuroplastic Pain

Fortunately, neuroplastic pain responds well to certain treatments:

• Pain Education: Simply understanding how pain works can significantly reduce fear and pain itself (Louw et al., 2016).

• Psychological Therapies: Approaches like cognitive-behavioral therapy (CBT) and mindfulness can help you manage pain by changing your brain’s response to it (Cherkin et al., 2016).

• Movement and Activity: Gradually engaging in gentle, guided physical activities can retrain your nervous system and decrease pain hypersensitivity (Geneen et al., 2017).

Why Understanding Neuroplastic Pain Matters

When you understand neuroplastic pain, you gain the power to tackle chronic pain from its roots—emotional, psychological, and neurological. This comprehensive understanding helps clinicians offer better treatments and empowers patients to manage their pain more effectively.

The Bottom Line

Neuroplastic pain is a revolutionary concept in understanding chronic pain. Recognizing its true nature can unlock new, effective paths to relief and recovery.

References

• Cherkin, D. C., et al. (2016). Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain. JAMA, 315(12), 1240-1249.

• Geneen, L. J., et al. (2017). Physical activity and exercise for chronic pain in adults: An overview of Cochrane Reviews. Cochrane Database of Systematic Reviews, 4, CD011279.

• Harvie, D. S., et al. (2015). Classical conditioning differences associated with chronic pain. Clinical Journal of Pain, 31(7), 602-611.

• Leeuw, M., et al. (2007). The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. Journal of Behavioral Medicine, 30(1), 77-94.

• Louw, A., et al. (2016). The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice, 32(5), 332-355.

• Lumley, M. A., et al. (2011). Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: A randomized controlled trial. Pain, 152(12), 2766-2774.

• Moseley, G. L., & Butler, D. S. (2015). Explain Pain Supercharged. Noigroup Publications.

• Nijs, J., et al. (2021). Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. The Lancet Rheumatology, 3(5), e383-e392.

• Woolf, C. J. (2011). Central sensitization: Implications for the diagnosis and treatment of pain. Pain, 152(3 Suppl), S2–S15.