Chronic pain is usually defined as pain that lasts longer than three months. For many people it feels more personal than a definition; pain that keeps going long after you expected it to fade, pain that does not match what clinicians can see on scans, and pain that begins to affect your confidence, sleep, work and relationships.
If this sounds familiar, you are not alone. Millions of people live with ongoing pain that does not come from ongoing tissue damage. This type of pain is very real, very common and often misunderstood.
Acute pain versus chronic pain
Acute pain is the kind most of us recognise. You cut your hand, twist an ankle or pull a muscle and the pain matches the injury. As the tissue heals, the pain gradually settles.
Chronic pain behaves differently. Even after tissues heal, the nervous system can stay sensitive and keep sounding a danger alarm. This does not mean the pain is imagined or all in your head. It means the pain is being generated by a nervous system that has become protective, hypersensitive, or over alert.
Neuroplastic pain - when the brain learns pain
Research from leading clinicians and pain scientists suggests a large proportion of long-term pain is neuroplastic pain. This is pain caused by changes in how the brain and nervous system process signals rather than by ongoing injury or disease.
Some common examples include:
- Back pain that started with an injury but continues years after scans look normal.
- Neck pain that flares during stress or poor sleep rather than heavy lifting.
- Migraines or headaches triggered by tension, uncertainty, or sensory overload.
- Pelvic or abdominal pain that is not explained by tests but worsens with fear.
- Pain that moves between areas or changes in intensity without a clear pattern.
In all of these situations the pain is real. The source is not damaged tissue; it is a nervous system stuck in protective mode.
Why the nervous system stays sensitive
Many people with chronic pain can trace things back to an injury, illness, or a stressful time. Instead of switching off once the threat has passed, the nervous system stays on high alert. This can be influenced by:
- Ongoing stress, uncertainty, or worry about the pain.
- Fear of movement or re injury and avoiding normal activities.
- Poor sleep, fatigue, or feeling run down.
- Past difficult experiences or trauma that keep the body on guard.
- Confusing or frightening medical appointments.
- Beliefs that something serious has been missed on tests.
These factors do not cause pain on purpose. They simply keep the nervous system on edge and more likely to send strong danger signals.
A more hopeful way to understand your pain
Many people feel a sense of relief when they learn that pain can continue without ongoing structural damage. Not because it makes the pain less real, but because it opens up new ways to recover.
When pain is neuroplastic, it can also change through neuroplastic approaches. This might include pain education, gentle somatic work, mind-body tools, emotional processing, nervous system regulation, and gradually returning to movement in safe, supported steps. Approaches used by practitioners like Alan Gordon, Howard Schubiner, and Lorimer Moseley build on this same principle - helping the brain and body feel safer.
Understanding this is often the first step towards reducing fear, rebuilding trust in your body, and learning how to calm a protective system that has been trying to look after you for a long time.