Your Pain May Be Neuroplastic–‘Train’ Your Brain for Relief

Letting go of difficult emotions and fears can rewire the brain to outsmart chronic pain.
Illustration by The Epoch Times
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A 29-year-old construction worker in London accidentally jumped onto a 15-cm nail that pierced through his shoe. He was in extreme pain.

The man was rushed to the emergency room and sedated with pain medication. However, when the doctors pulled out the nail and took off the man’s shoe, they discovered that his foot was completely untouched. The nail had neatly slid between his toes without penetrating his foot.

Published in the British Medical Journal in 1995, this famous medical case highlights how pain can be neuroplastic, meaning the brain can trigger pain signals without any physical injury.

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The construction worker’s brain generated pain when it perceived danger and stopped generating pain when it perceived no danger, said Yoni Ashar, a clinical psychologist and assistant professor of internal medicine at the University of Colorado Anschutz Medical Campus.

“All pain is brain-generated, and regardless of whether or not that pain is associated with a true injury, that pain is real,” Ashar told The Epoch Times.

Neuroscience indicates that the brain’s pain pathways are linked with and influenced by emotions, such as fear or anticipation of pain, psychological stress, and trauma—and that addressing emotions is integral to treating persistent pain, also known as chronic pain, which medical science defines as pain that lingers beyond three to six months.
Recognizing and releasing repressed emotions, including pain-fearing beliefs, can help rewire the brain to “unlearn” chronic pain.

It’s Your Brain That Creates Pain

Pain is an alarm signal sent by the brain to alert the body of possible danger. According to the “predictive coding” model, the brain can create pain in response to an actual injury—or it can predict pain based on fear, anticipation, or past painful experiences. This can lead to a cycle in which fear and pain reinforce each other, prolonging the experience of pain.
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The brain is a unique organ because of its plasticity, or ability to change and make new neural connections. Plasticity allows us to learn new skills and languages or recover from brain injuries like strokes. However, neuroplasticity also means the brain can learn things like pain, according to Ashar.

Stress, depression, or anxiety can put the brain on high alert or in fight-or-flight mode, he said.

The brain that is stuck in the high-alert mode causes a release of stress hormones into the bloodstream. Such a hypervigilant brain can erroneously send danger signals even when no real threat is present. Over time, these incorrect signals may become hardwired into our nervous system, leading to chronic pain.

“The good news is that we can harness that same plasticity to help your brain unlearn your pain,” Ashar said.

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Dr. Alejandro Centurion, a neurologist based in New York, told The Epoch Times that while neurological problems can cause chronic pain, often the chronic pain is not connected to structural problems but to emotional ones.

According to Centurion, this happens when people avoid emotional stressors that the conscious mind doesn’t want to process. At a subconscious level, that emotional distress becomes physically expressed in the body. Back pain is just one common area where this tends to manifest, enabling the brain to focus on physical pain rather than emotional discomfort, he said.

Traditional Chinese medicine and Ayurveda have long recognized the mind-body connection, viewing emotions, energy, and physical health as deeply interconnected. Modern research is now validating the role of neuroplasticity, stress, and emotions in chronic pain and illness, leading to a more integrative understanding.

The Mind-Body Link in Back Pain

Back pain is a leading cause of disability worldwide.
Approximately 20 percent of American adults experience chronic pain, with chronic low back pain impacting close to 10 percent of the population, according to Centurion. About 90 percent of chronic low back pain has no clear structural cause that would require surgery, and imaging studies often show “normal age-related changes” in the discs.
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Based on neuroscience research on chronic pain, “there is a slow but growing recognition among the medical community that chronic back pain is influenced by the brain’s pain processing system, stress, and emotions,” he said.

Besides pain relievers such as steroidal and non-steroidal anti-inflammatory drugs and opioids, which are used to manage chronic pain, studies have shown that several mind-body-centered psychological options, such as pain reprocessing therapy (PRT), meditation, and qi-gong (exercises to move energy) can effectively relieve chronic back pain by calming the nervous system and rewiring the brain’s pain pathways.

The late physician John E. Sarno, one of the pioneers of mind-body medicine, referred to emotion-triggered pain disorders as Tension Myositis Syndrome (TMS), also known as the mind-body syndrome. Several well-known individuals, including Jimmy Kimmel, Howard Stern, Larry David, and Anne Bancroft, have publicly credited Sarno with curing their back pain after reading his books.

In his book “Healing Back Pain: The Mind-Body Connection,” Sarno offers 12 daily reminders to help people manage chronic pain, including:
  • My body is normal, and there’s nothing to fear.
  • Pain is a harmless sensation and distracts my attention from difficult emotions.
  • My repressed anger is the key emotional issue.
  • I am in charge and not my subconscious mind.
  • I will focus on the psychological and not the physical.
The core techniques of the method are mindfulness meditation, positive affirmations, and journaling.
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Centurion, a neurologist with more than 20 years of experience, recalls one of his patients with chronic lower back pain who found relief using Sarno’s method. The patient was struggling with chronic pain and had tried physical therapy and a variety of methods without significant relief.

The daily reminders and the pain-emotion connection helped the patient realize that he’d been harboring years of anger and resentment toward his mother over a family issue. He believed his mother had treated him unfairly when distributing the family inheritance. As the man began to let go of his hard feelings, his chronic pain gradually disappeared.

In another instance, a young biochemistry student from London named Charli recounted in a short film how she recovered from more than two years of chronic back pain. She had even tried a high dosage of opioid painkillers without success.

Charli began journaling following the mind-body technique. Even before she realized it, writing in her journal helped her release emotions from her childhood to adulthood that may have been building up tension and contributing to her stress. At first, she felt writing about things that annoyed her was pointless. But, she said, emotions often come out while journaling that one doesn’t even think about. It helped her process difficult emotions, and she began to feel her pain fading away.

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Now, whenever she experiences new physical symptoms, she first looks inside, reminding herself to see how she is feeling at the moment. She considers painful sensations a message from her body asking her to “tune into something” she might have been ignoring. She said that the human body is so much more powerful than we think, and we have the tools within us to help ourselves.

Experts in neuroscience and psychology have expanded on Sarno’s mind-body principles to apply neuroplasticity and stress-related pain research to chronic pain conditions. One of these evidence-based treatments is Pain Reprocessing Therapy, which rewires the brain to “unlearn” chronic pain.

Pain Reprocessing Therapy

Pain Reprocessing Therapy aims to reduce or eliminate chronic pain. It employs several techniques to help people retrain their brains to interpret chronic pain as a safe sensation instead of an injury.

Somatic tracking is a core PRT technique that encourages patients to observe their pain with curiosity and reconceptualize it as physical sensations that are not harmful. They are guided to participate in routine activities, such as walking or bending, which they may have been avoiding due to fear of pain, and reappraise painful sensations as safe by reframing their pain beliefs. Finally, PRT addresses the emotional element of pain—patients are guided to recognize and process their stress, anxiety, and past trauma and cultivate positive feelings.

PRT helps patients break the pain-fear cycle and rewire the brain’s neural connections.

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In 2021, Ashar and his team conducted the first-ever clinical trial to study the impact of PRT on people with chronic back pain. Neuroimaging scans indicated that participants who received PRT had reduced brain activity in several regions associated with pain processing.

The results showed that 66 percent of patients in the PRT group became pain-free or nearly pain-free at the end of four weeks of treatment, compared to 20 percent in the placebo group and only 10 percent in the usual care group that had continued their ongoing care without receiving any other treatment during the trial. The health gains were largely maintained through one-year follow-up.

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The response rates of patients from the PRT, placebo, and usual care groups becoming pain-free or nearly pain-free from chronic back pain after 4 weeks of treatment, and one-year follow-up. The Epoch Times

Following the completion of PRT, participants were interviewed about their experiences. They described the pain-emotion connection as a crucial treatment component and that PRT helped them distinguish between two types of pain: pain caused by injury and pain resulting from emotional discomfort. They showed a shift in mindset regarding their perception of pain.

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People often attribute their chronic pain to physical factors such as age, weight, posture, or an old injury, and PRT aims to change these attributions, Ashar said.

Qi-Gong Exercises and Meditation

Qi-gong (pronounced chee-gong) is a traditional Chinese mind-body system consisting of slow-moving exercises, breathing techniques, and focused mindfulness and meditation techniques that help balance energy, called qi or vital force, inside the body to achieve optimal health. Apart from the physical aspect, qi-gong techniques also focus on cultivating one’s inner nature and a compassionate and forgiving spirit, guiding people to let go of the negative and embrace the positive.
In the past few decades, qi-gong exercises have gained popularity worldwide due to their benefits for several health conditions—and chronic lower back pain is one of them.
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Research has shown that qi-gong exercises like meditation are beneficial for various health conditions. Photo courtesy of Adhiraj Chakrabarti
A recent study of U.S. military veterans with chronic low back pain showed that qi-gong practices can significantly reduce pain. The research found that the participants assigned to eight weeks of qi-gong exercises experienced a significant decrease in all pain-related outcomes, including pain intensity, low back pain-related disability, and sleep disturbances, compared to the control group.
Further, a clinical trial of a mindfulness routine of under two hours a week demonstrated significant improvements in disability and quality of life of patients with chronic back pain, with more than 80 percent of participants describing improvement in their pain symptoms immediately after eight weeks.

Ashar believes non-pharmacological approaches like pain reprocessing therapy and related treatments could have a huge effect on this intractable problem in health care, offering “a promising path forward—one where recovery from chronic pain is possible.”

Arsh Sarao is a health reporter for The Epoch Times. She holds a Master's degree in Biotechnology and a Bachelor's degree in Biology and Chemistry. She taught life sciences for 11 years before working as an editor for Epoch Inspired for 7 years. She focuses on health, wellness, and traditional value topics.