Neuroplastic pain is one of three main types of pain. It is the main type of pain behind chronic pain. It is just as real as the types of pain that are more based on structural issues, such as nerve damage or broken bones. There are ways to figure out if the pain is neuroplastic or one of the two structural types of pain (nociceptive or neuropathic). There is research that shows it is treatable with the right psychotherapeutic techniques.
What is Neuroplastic Pain?
Neuroplastic pain, also called nociplastic pain or primary pain, is generated by the brain, despite there being no significant damage to the body that is causing the pain. It is real pain. It is legitimate pain.
Pain is a danger signal, usually warning you that something is wrong and you should pay attention to it. Unfortunately, neuroplastic pain is a software issue. There is no significant damage or danger that you need to be warned about. The brain is making mistakes by interpreting non-dangerous sensations or stimuli as dangerous and creating a pain response. Neuroplastic pain can also be pain that has remained after an injury has healed and the brain keeps the pain signal in the “ON” position. It is like a fire alarm going off in an apartment building and the fire department needs to turn it off, but the fire department has not shown up and the alarm keeps going despite there not being a fire.
Even when there is nociceptive or neuropathic pain (pain caused by damage to the body), there can still be neuroplastic pain. A mixed presentation of pain (both neuroplastic pain and either nociceptive or neuropathic pain) can mean that the pain caused by these other types of pain can be amplified. The actual damage to the body could be experienced as a 2 or 3 on a pain scale, but the neuroplastic part of the pain presentation could cause that pain to be experienced as much higher on a pain scale. A mixed presentation of pain is like the volume control on your TV, where you can amplify the sound, but it’s the things that your brain is sensing as dangerous that is amplifying the pain.
Neuroplastic pain can get very intense. This may be very distressing for you because your limitations due to the pain can change and increase as the pain wants to be heard and it spreads to other parts of your body. Furthermore, the distress caused because doctors can’t figure out why you are in severe pain can make it worse. Ultimately, it can be disabling and severely affect your mental health.
What are some of the symptoms of neuroplastic pain?
• Pain that did not start with an injury (neuroplastic pain can develop from an injury that is still causing pain after the injury has healed).
• Symptoms began during a time of stress.
• Symptoms are inconsistent (symptoms move or spread; delayed onset, such as after an activity or exercise).
• Symptoms do not make sense by Known Structural Conditions
• Symptoms that are triggered by factors that have nothing to do with the body, such as stress, trauma, or conditioned responses.
• Co-occurring mental health conditions (they carry similar vulnerabilities and mechanisms)
What can make it more likely that you would develop neuroplastic pain?
• History of childhood adversity
• Presence of certain common personality traits, such as perfectionism, conscientiousness, people pleasing, and anxiousness.
• Family history of chronic pain
Neuroplastic Pain Based Conditions
These are some of the conditions that are often considered to be neuroplastic pain based or mostly neuroplastic pain based…
- Migraines
- Tension Headaches
- Fibromyalgia
- Complex Regional Pain Syndrome
- Chronic Low Back Pain
- Irritable Bowel Syndrome
- Bladder Pain Syndrome
Is Neuroplastic Pain Treatable?
The best part of neuroplastic pain is that it is treatable by retraining the brain. Since the pain is caused by mistakes the brain is making in interpreting sensations and signals from the body as threats, it can be treated by retraining the brain that those sensations and signals are not dangerous but safe. There are techniques and strategies that have been found to be very effective in scientific studies. This may not be easy as for many people they have been stuck in the same patterns for years desperate for relief but relief from neuroplastic pain is possible.
Pain Processing Therapy
Pain Reprocessing Therapy is a system of psychological techniques for use with neuroplastic pain. It is focused on breaking the fear-pain cycle by retraining the brain away from faulty misinterpretations fueled by fear and threat towards a more accurate view that is based on safety. In the Boulder Back Pain study, it was found that Pain Reprocessing Therapy improved the pain for 98% of patients and 66% of patients were pain-free or nearly pain-free at the end of treatment (2 sessions per week for 4 weeks) and that these outcomes were maintained one year later. You can read more about the study here: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2784694
Emotional Awareness and Expression Therapy
Emotional Awareness and Expression Therapy is a form of psychological therapy that is designed to help patients attribute their pain and other symptoms to emotionally activated central nervous system mechanisms and become aware of, experience, and adaptively express their emotions stemming from adversity, trauma, or conflict. In various studies, Emotional Awareness and Expression Therapy was found to be effective for Fibromyalgia, Somatic Symptom Disorder, Irritable Bowel Syndrome, Chronic Pelvic Pain, Medically Unexplained Symptoms, and Chronic Pain.
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.620359/full
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680092/
https://pubmed.ncbi.nlm.nih.gov/32451528/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309024/
Also see: Chronic Pain
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