Mr. Murphy has been a Physical Therapist for 11 years and has a pain coaching business.  Recently he was certified in Pain Reprocessing Therapy. Personal experience with repeated bouts of back pain and unsuccessful treatments as he worked in a geriatrics/home health setting derailed his career and family plans.

One of his therapists tried to tell him about mind and body approaches and the science of pain and he just didn’t get it. Now he has learned that pain is a lot more complicated than just a message signal that travels up through your body from an injury and rings a little pain bell in your brain.

The most common cause of long-term pain is different from acute pain. Researchers have found that only about 10% of long-term pain is caused by existing physical or structural problems. Most long-term pain results from neuroplastic causes or origins, meaning there’s been some change within the nervous system that produces the pain.

Neuroplastic pain is a brain mistake, safe sensations within the body are interpreted as dangerous. In Mr. Murphy’s case, “My back had healed but the sensations in my body around my back were no longer being interpreted as safe by my brain and my nervous system.” Analogies of neuroplastic pain are an extremely loud hearing aid setting or a mis-calibrated alarm system.  Neuroplastic pain mistakes can be changed.

Regardless of its cause, all pain is real.  It is all experienced in the body. In fact, researchers have found that neuroplastic pain mimics real physical pain in any part of the body and the same areas of the brain are involved with that experience of pain.

Researchers use a “functional MRI” to look at real time brain activity. When human subjects are poked with a hot probe to provoke pain, certain parts of their brain light up with activity. If subjects were told under hypnosis that they were being poked with a hot probe, the same areas of the brain lit up with pain and they reported experiencing pain. It doesn’t matter whether they have acute pain or neuroplastic pain, the same areas of the brain are involved with that same pain experience.

This whole idea was a real turning point for Mr. Murphy—he felt hopeful enough to try mind-body treatment approaches instead of thinking that repeated injuries to his back were causing his pain.

The whole goal of mind and body treatment approaches is to help the brain begin to reinterpret those sensations as “safe” or “neutral” and reduce or turn down the neuroplastic pain level. Going back to his hearing aid analogy—it’s possible to reduce the amplification of these sensations in the body so they no longer experienced as long-term pain.

Researchers using functional MRI scans of brain areas have found the following effects associated with mind body practices to reduce neuroplastic pain:

1. When neuroplastic pain is present, pain areas in the brain are active all the time and the pain interferes with sleep, digestion, the endocrine and immune systems–all kinds of normal body functions.
2. After the subjects have engaged in mind-body practices, they report reduced neuroplastic pain. Repeat brain scans show that the previously active pain areas have quieted down and are engaged in their normal brain functions. And when subjects experience an acute injury (prodding with a hot probe), the brain scans light up, then go back to their normal resting state, and wait to warn of danger rather than just being on constantly.

What are mind and body approaches? Common ones are yoga and tai chi, meditation, mindfulness, somatic tracking, guided imagery. There are tons of resources—You Tube, books, websites, videos. Two resources that effectively blend mind-body approaches with pain science education are the Curable app and Pain Reprocessing Therapy.

How can it be determined if long-term pain is due to neuroplastic causes/changes in the brain and the nervous system?  Symptom patterns in people who have neuroplastic pain are very different from symptom patterns associated with structural or physical-caused pain. He provides a list of eleven characteristics of neuroplastic pain.

Mr. Murphy has put together an online neuroplastic pain questionnaire and can give you a personalized response to help you determine if your pain is neuroplastic. Pain Reprocessing Therapy Pain Quiz (murphypaincoaching.com)

In summary, yes, your pain is real. If you’ve had it a long time or a short time, from an injury or not–no matter where it’s coming from, pain is real. The reason that healthcare treatments for your pain have failed may be because they’ve been focused on the wrong target. If treatments have been focused on physical structural problems, but long-term pain is usually neuroplastic, that is, a change in the nervous system rather than in body tissues. But there’s hope. Neuroplastic pain is reversible. Mind body approaches are very effective at helping to retrain the brain, calm down the nervous system, and help reduce pain.