Understanding Chronic Pain

My approach to chronic pain is based on the work of Dr. Howard Schubiner and the model of neuroplastic pain. Years of research have shown that 80 to 90% of chronic pain is not caused by ongoing tissue damage, but by changes in the brain and nervous system that generate very real pain in response to false signals of danger or fear.

Pain is produced by the brain. It is the brain's alarm system — designed to protect us from danger. In neuroplastic pain, that alarm becomes overprotective: learned neural pathways keep firing long after any injury has healed, and stress, fear, and strong emotions can keep the signal switched on. The pain is 100% real, but it reflects a sensitized nervous system rather than damage that needs more scans or surgery.

The encouraging news is that what the brain has learned, it can also unlearn. Because the nervous system is neuroplastic — able to change — these pain pathways can be reversed. Understanding this is the first and most important step toward recovery.

Regular aerobic exercise is one of the most powerful tools for chronic pain and overall health. Activities such as brisk walking, cycling, and swimming improve circulation, release natural pain-relieving endorphins, lift mood, improve sleep, and help regulate an over-sensitized nervous system.

In neuroplastic pain, gentle movement does something more: it teaches the brain that the body is safe to use. When you move without bracing for harm, you gradually break the cycle of fear and avoidance that keeps pain pathways active. Aim for a gradual, graded approach — start small, stay consistent, and build up over weeks rather than days.

A reasonable goal for most adults is about 150 minutes of moderate aerobic activity per week, combined with good sleep, a balanced diet, stress management, and social connection. If a flare-up occurs, it does not mean you caused damage — ease back gently rather than stopping altogether. Check with your physician before beginning a new exercise program.