Throughout the last years, I’ve taken a deeper dive into learning about pain, in particular chronic, persistent pain. I enrolled in a Pain Reprocessing Training (PRT) after listening to, “Tell Me About Your Pain” podcast to compliment my understanding of the Feldenkrais Method®.

I come to this learning with great humility, knowing that people’s circumstances vary immensely and I don’t with to simplify anyone’s life experience. I’d love to hear about your experiences and continue my learning through the comments below.

Some things I’m learning:

Pain: Pain is a healthy aspect of our nervous system. Pain is a danger signal, when something is painful, our nervous system sends a message to the brain to help us act in a way to protect ourselves from harm. For example, if you put your hand on the stove, you would experience a painful sensation which will cause you to move your hand away and not cause any damage.

Pain is a healthy danger signal which keeps us alive.

However, like all different kinds of conditioning, our nervous systems can become conditioned to interpret sensations or stimuli as dangerous, when there is actually no threat. It’s similar to someone who for example had a bad experience with a dog when they were young and for the rest of their life they don’t trust dogs. Our brain can go into hyper-vigilance and send out a larger alarm (pain) signal than is necessary, or accurate for the present moment.

There was a story told a few times in my PRT training about a construction worker who accidentally hammered a big nail through the top and bottom of his boot. He called out in agony and was rushed to the ER. He was in major distress. At the ER the doctors carefully removed the boot and discovered that the nail hadn’t actually touched his foot, it had gone perfectly between his toes. There was no tissue damage. Upon seeing this, the sensation of pain disappeared for the man and he was fine.

His agony and distress had been created by the brain based on what he imagined had happened.

What is Neuroplastic Pain?

Neuroplastic pain is when the brain gets into a habit or cycle of interpreting sensations as dangerous and creates a sensation of pain, even when there is no risk or tissue damage.

Spectrum of Tissue Damage to Neuroplastic Pain

All pain falls on some spectrum between tissue damage and neuroplasitc pain. It is rarely 100% either. “Injury can occur in the absence of pain, and pain can occur in the absence of injury” - Rachel Zoffness. We can influence neuroplastic pain by creating safety for the brain.

Pain is Subjective and Changeable

Pain does not occur in a vacuum. Two people can experience the same injury and have a very different experiences of pain. Rachel Zoffness has a wonderful model for understanding all of the factors that contribute to the persistence and intensity of pain.

She says, “research and clinical evidence indicate that pills and procedures alone are insufficient for effectively treating chronic pain… Because your brain is connected to your body 100% of the time, your social health, emotional health and physical health are intricately, inextricably intertwined.”

Our experience of pain is influenced not just by injury, but by our social, psychological and biological state.

There can be a misconception when first learning about neuroplastic pain that “pain is all in your head.” That’s NOT true. The pain sensations are real, your experience of pain is real. However, they are also subjective and can be increased or decreased based on your biopsychosocial habits.

Here are some factors which influence your biopsychosocial state:

The work of Moshe Feldenkrais points to the same conclusion:

In order to heal and understand chronic pain, we have to include all aspects of life, not just physical.

Skills for Improving Neuroplastic Pain:

1) Nurturing and soothing the fearful part of the brain when pain arises

2) Taking time to turn towards the pain, listen and allow the pain. Explore the sensations with curiosity.

3) Learning to trust that sensations aren’t dangerous

4) Noticing inner attitudes like being hard on oneself, people pleasing, neglecting self-care, holding in emotions

5) Practicing feeling pleasure, noticing pleasant sensations, exposing the brain to enjoyment

Feldenkrais and Chronic Pain:

Here are some ways that the practice of Feldenkrais helps to improve chronic pain—

1) Spending time re-training the brain to more frequently experience pleasant sensations

2) Moving slowly in ways that the brain has historically perceived as dangerous. I’ve heard, “going slow is the antidote to fear.” Moving slowly can rebuild trust.

3) Improving movement Organization so that certain areas of the body which overwork can be relieved of stress and rest

4) Cultivation of curiosity, “Curiosity can be used to interrupt and change a pain pattern” - Deborah Bowes

5) Regulating the Nervous System, bringing the nervous system into a calm, parasympathetic state can decrease fear and vigilance

6) Shifting to a learning mindset instead of a fixed outcome mindset. “This learning methodology asks the student to shift away from the urge to succeed and stay in the process of learning. Learning actively restores a healthier function of the nervous system by evoking curiosity.” - Deborah Bowes

7) Allowing avoided feelings to emerge, by slowing down we make space for feelings to surface which have been repressed. In this way they can be known and healed.

8) Improving awareness and ability to sense when pain cycle is beginning and make a supportive choice for oneself.

Want to dive deeper into healing your chronic pain?

We ran this course in the fall of 2023:

Please share comments, feedback and about your experiences in the comments below.

Resources:

ZOFFNESS, R. (2021). Pain management workbook: Powerful CBT and mindfulness skills to take control of pain and... reclaim your life.

Gordon, A. Whole series. Tell Me About Your Pain Podcast

4 Week Pain Reprocessing Therapy Training - March 2022

Elgelid, S., & Bowes, D. (2021). Pain and Curiosity. In C. Kresge (Ed.), The Feldenkrais Method: Learning Through Movement (pp. 187–195). essay, Handspring Publishing Limited.

Pain is a Spectrum