How We Learn to Be in Pain—And What Can Actually Help

Honestly, this is such an important post for me. Having been someone who struggled with life-changing chronic pain for years, I thought I had tried EVERYTHING!!! If you saw it on social media or the internet, I had probably done it.

Some things made me feel better for a little while, but EVERYTHING was very short-lived. This includes all sorts of training methods, exercises, and treatments. It wasn’t until one day when I was sharing with Jessica how defeated I felt—and really, how I felt like a poor coach (how could you coach others when you’re hurting, right?)—that things changed.

First, she reminded me that disease can dramatically change your world, and being more compassionate toward yourself is important. I hate it when she’s right! But what she said next would be a game changer in every way.

Having worked with many neurological patients, Jessica said, “I think you’ve learned to be in pain.”

WHAT?! What does it mean to learn to be in pain?

Jess explained that the brain has many pathways, not only for movement but also for how we experience life. (We don’t actually see with our eyes or hear with our ears—we do those things with our brain.) The more we repeat something, the stronger those pathways become. There’s a saying in neuroscience: “Neurons that fire together, wire together.”

Since I had been in pain for about nine straight years (I had seven surgeries in that time due to disease), the neural pathways associated with pain had learned that my “normal” was to be in pain. If that sounds far-fetched, here’s a very scientific explanation of the concept:

“…chronic pain may be viewed as a brain disease state, but in this case initiated by peripheral nociceptors, and either extinguished or maintained by factors predisposing the extent to which the mesolimbic emotional learning circuitry reacts to the inciting event… we redefine chronic pain as pain that does not extinguish its memory trace…” (PMID: 23603439)

In our last post about chronic pain (HERE), I shared that MANY things can help—especially from an exercise perspective. However, exercise is not generally found to eliminate pain. That doesn’t mean we shouldn’t use core stability, strength training, aerobic exercise, and stretching—we SHOULD. But we can’t overlook the impact of the brain, because ALL pain is created in the brain, and we have to understand how changes in brain structure affect our experience of pain.

To illustrate this point, a 2021 study of 151 people with back pain lasting over 10 years compared a placebo, usual care, and a brain retraining method called Pain Reprocessing Therapy (PRT). In just 4 weeks of PRT, 66% of participants were pain-free or nearly pain-free. That same level of improvement was still found a year later. If you aren’t familiar with pain research—this is HUGE. That kind of outcome in such a short time frame is almost unheard of, especially compared to what exercise alone can produce.

Now, PRT is a great program, but it’s quite intensive and typically used by pain psychologists and social workers (although I do encourage people to learn more about it). So how can we bring some of these concepts into fitness and other arenas to tackle the challenge of chronic pain?

While regular physical activity is good for the brain, typical strength training doesn’t seem to create long-term changes in gray matter, which is crucial for emotional regulation and pain perception. However, there’s strong evidence that mind-body practices DO have long-term benefits for brain changes (PMID: 32182844, 30761046, 28869478).

So, what’s the difference between mind-body fitness and traditional strength or aerobic training? The difference can be profound. Mind-body fitness has been shown to be TWICE as effective at reducing chronic pain compared to aerobic training (PMID: 29563100).

The slower, intentional movements—combined with deep breathing, meditation, mindfulness, and enhanced body awareness—alongside improved cardiovascular health, are all reasons mind-body fitness can be so effective in changing the brain and managing chronic pain.

Mind-body practices work on both the brain, but body as well in reducing inflammation factors. 

This isn’t just a wild idea—it’s extensively researched across different populations, including veterans:

Cheryl Krause-Parello, Ph.D., professor and director of Canines Providing Assistance to Wounded Warriors (C-P.A.W.W.), notes: “Our review provides emerging evidence that movement-based mind-body interventions could benefit veterans and others experiencing chronic low back pain.”

Even young adults in their 20s (who are increasingly dealing with stress-related chronic pain) are finding mind-body fitness helpful for issues like low back pain (PMID: 24926131).

 

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So, helping chronic pain isn’t about doing ONE thing, and it definitely isn’t about overwhelming yourself by trying to do EVERYTHING. Instead, we want to offer ways to turn all this science and strategy into accessible and doable programs.

That’s why we hope you’ll join us for our 6-week online Chronic Pain Masterclass, starting April 15th HERE. This is the LAST week to save on this incredible program and earn 10 contact hours for CEUs. You can also learn more about our mind-body fitness approach with our Myofascial Integrated Movement (MIM) programs HERE and save 20% with code “save20”.

 

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