Your Brain on Pain: What's Actually Going On Up There?
Your brain doesn't just receive pain—it creates it. Here's why that's actually good news.
Here's something that might change how you think about your pain forever: Your brain isn't just receiving pain signals like a passive radio. It's actively creating your pain experience, deciding how much you feel, and even choosing which signals to pay attention to.
Think that sounds crazy? Consider this: You can cut your finger while cooking and not notice until you see the blood. Or you can have phantom pain in a limb that's no longer there. Your brain is calling the shots way more than you realize.
And here's the plot twist: Understanding how your brain creates pain is actually empowering. Because if your brain learned to amplify pain, it can also learn to dial it back down.
🧠 Meet Your Brain's Pain Department
Forget everything you learned about pain being a simple message from your body to your brain. Pain is actually created by a complex network of brain regions working together like a busy office.
🏢 Your Brain's Pain Office includes:
🚨 The Alarm Department (sensory areas that detect signals)
📋 The Evaluation Team (decides if signals are dangerous)
😰 The Emotional Response Unit (adds feelings to the experience)
📚 The Memory Division (compares to past experiences)
⚖️ The Executive Decision Makers (determines final pain experience)
All these departments talk to each other constantly, and they don't always agree. Sometimes the Alarm Department is screaming "DANGER!" while the Executive Decision Makers are saying "Actually, we're fine."
In chronic pain, this office has basically become paranoid and overprotective.
🛣️ The Pain Highway System: How Signals Travel
🚗 The Journey Begins: When something happens to your body (injury, inflammation, pressure), specialized sensors called nociceptors detect it and send a signal up your spinal cord toward your brain.
But here's where it gets interesting: That signal doesn't just zoom straight to your brain like a text message. It travels through what scientists call the "pain highway system," and there are multiple checkpoints along the way.
🚧 Checkpoint #1: The Spinal Gate Your spinal cord has a "gate" that can open or close to let pain signals through. This is why rubbing your elbow after you bang it actually helps—the rubbing signals can "close the gate" and block some pain signals.
🚧 Checkpoint #2: The Brain Stem Filter Your brain stem acts like a security checkpoint, deciding which signals deserve your brain's attention. If you're focused on something important, it might let fewer pain signals through.
🚧 Checkpoint #3: The Brain's Final Decision Multiple brain regions vote on what your final pain experience will be. They consider factors like:
What's happening in your body
Your emotional state
Past experiences with pain
What you believe about the pain
Your stress levels
What you're paying attention to
🔄 What Changes in Chronic Pain Brains
Here's where the science gets really fascinating (and explains so much about your experience): Chronic pain literally rewires your brain.
📈 The Volume Gets Stuck on High: Areas of your brain that process pain become hyperactive and grow larger¹. It's like your brain's pain amplifier got stuck on maximum volume. Normal sensations that shouldn't hurt—like gentle touch or movement—now get cranked up to painful levels.
🚪 The Gates Stop Working Properly: Those helpful "gates" that normally filter pain signals? They start malfunctioning. Instead of blocking unnecessary signals, they let everything through—and sometimes even amplify signals that shouldn't be painful.
🧩 The Networks Get Tangled: Pain processing networks in your brain start talking to other networks they shouldn't, like areas involved in:
😟 Emotional processing (making pain more distressing)
😰 Stress response (keeping you in fight-or-flight mode)
💭 Attention (making it hard to focus on anything but pain)
😴 Sleep regulation (disrupting restorative sleep)
🔄 The Prediction Problem: Your brain becomes obsessed with predicting and preventing pain. It starts treating normal activities as dangerous, creating pain even when there's no actual threat to your body.
✨ The Neuroplasticity Hope: Your Brain Can Change Again
Here's the amazing part: The same neuroplasticity that allowed chronic pain to take hold can work in your favor.
🔧 Your Brain is Retrainable: Just like your brain learned to be hypervigilant about pain, it can learn to calm down again. This isn't wishful thinking—it's measurable science. Brain scans show that effective chronic pain treatments actually change brain structure back toward normal².
🎯 The Key is Consistency: Your brain changes based on what you repeatedly do and think. Every time you:
Move despite mild pain
Practice relaxation techniques
Focus on something other than pain
Challenge catastrophic thoughts about pain
Experience moments of joy or accomplishment
You're literally rewiring your brain toward better pain processing.
🛠️ Practical Applications: Working With Your Brain
Understanding your brain's role in pain isn't just interesting—it's actionable. Here's how to use this knowledge:
🧘♀️ Attention Training
What's happening: Your brain amplifies whatever you focus on. Constantly monitoring pain makes it louder.
What to try:
✅ Practice mindfulness meditation
✅ Engage in absorbing activities that capture your attention
✅ Use guided imagery or visualization
✅ Try the "noting" technique: acknowledge pain without diving deep into analyzing it
🏃♀️ Movement as Medicine
What's happening: Your brain learns that movement is dangerous when you avoid it due to pain.
What to try:
✅ Start with tiny, non-threatening movements
✅ Celebrate small victories to teach your brain that movement can be safe
✅ Gradually expand your movement comfort zone
✅ Focus on how movement feels good, not just on pain
💭 Thought Pattern Retraining
What's happening: Catastrophic thinking (like "this will never get better") actually increases pain signals.
What to try:
✅ Notice and gently challenge doom-and-gloom thoughts
✅ Practice realistic but hopeful self-talk
✅ Keep a "evidence against catastrophe" list
✅ Work with a therapist trained in chronic pain if needed
😴 Sleep as Brain Medicine
What's happening: Poor sleep makes pain processing worse and prevents brain healing.
What to try:
✅ Prioritize sleep hygiene like it's medication
✅ Create a consistent sleep schedule
✅ Use relaxation techniques before bed
✅ Address sleep disorders that might be lurking
🤝 Social Connection Rewiring
What's happening: Isolation and feeling misunderstood activate brain stress systems that amplify pain.
What to try:
✅ Connect with others who understand chronic pain
✅ Maintain relationships that bring you joy
✅ Practice asking for support in specific ways
✅ Consider support groups or online communities
🔬 The Science of Hope
Research shows that people who understand the neuroscience of their pain actually experience less pain and better function³. Simply knowing that:
Your pain is real but not necessarily indicating damage
Your brain can change and adapt
You have some influence over your pain processing
Pain doesn't have to control your life
...can begin shifting how your brain processes pain signals.
This isn't about "thinking your way out of pain" or pretending it doesn't exist. It's about working skillfully with your brain's natural ability to adapt and change.
💪 Your Brain-Based Action Plan
🎯 Start Here:
Notice without judgment: Pay attention to how your thoughts, emotions, and activities affect your pain levels
Pick one brain training approach: Choose from attention training, movement, thought work, sleep improvement, or social connection
Be consistent: Small, regular efforts work better than occasional big pushes
Celebrate small wins: Your brain learns from positive experiences too
🧠 Remember:
Change takes time—be patient with yourself
Setbacks are normal parts of brain retraining
You're not trying to eliminate pain completely, but to reduce its grip on your life
Every small positive change is evidence that your brain is capable of healing
The bottom line: Your brain created your chronic pain experience, but that same incredible brain has the power to change it. You're not broken—you're trainable.
Ready to put this brain science into action? Download our free "Your Brain on Pain Action Summary" - a one-page guide with all 5 brain training strategies you can print and reference anytime you need a reminder of how to work with your pain, not against it.
📚 References:
Apkarian, A.V., et al. (2013). "Pain and the brain: specificity and plasticity of the brain in clinical chronic pain." Pain, 152(3), S49-S64.
Seminowicz, D.A., et al. (2011). "Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function." Journal of Neuroscience, 31(20), 7540-7550.
Moseley, G.L. (2007). "Reconceptualising pain according to modern pain science." Physical Therapy Reviews, 12(3), 169-178.
