Understanding Neuroplastic Pain aka Learned Pain

Over the past few years, I’ve been on a learning journey to understand the root cause of chronic pain that has no structural or mechanical cause. I’ve struggled with chronic tension and anxiety most of my adult life, but it wasn’t until part way through my Feldenkrais® Training (2018-2022) that I developed persistent chronic pain. Despite immersing myself in Feldenkrais® self-study and practice, my chronic pain symptoms were getting worse. This article is an opportunity to share what I’ve learned about chronic pain that just won’t go away, despite doing all the “right” things. 

When it comes to healing chronic pain, it’s important to understand what type of pain you are experiencing. There are three types of chronic pain: nociceptive, neuropathic, and nociplastic (also known as neuroplastic or learned pain). 

  1. Nociceptive pain is caused by actual tissue damage and inflammation, such as a strained muscle or sprained ankle. It typically doesn’t last longer than three months after the injury or tissue damage has healed.
  2. Neuropathic pain is caused by damage to the nervous system, typically resulting from spinal cord injuries or chronic disease (such as diabetes or multiple sclerosis).
  3. Nociplastic or neuroplastic pain arises from altered nociception in the absence of tissue or nervous system damage. With this type of pain, the central nervous system becomes sensitized (or overly responsive) to normal or subthreshold stimuli.

Neuroplastic type of pain persists beyond three months (often for years) and is what most chronic pain sufferers are dealing with. Neuroplastic pain is associated with chronic pain conditions such as migraines, back pain, neck pain, fibromyalgia, and chronic fatigue syndrome. Any body pain that is widespread, inconsistent, and triggered by stress is likely neuroplastic.

The root cause of neuroplastic pain is the brain’s misinterpretation of harmless signals as danger, leading to the development of “learned” pain pathways. The following section explores this process more in-depth.

Central Sensitization: The Process Through Which Neuroplastic Pain is Learned

Central sensitization is a process that makes the central nervous system more sensitive to pain and other sensory stimuli. It can cause chronic pain and other symptoms, such as fatigue, brain fog, and mood changes.

A person with central sensitization may perceive pain from normally non-painful stimuli (allodynia) and experience greater pain from painful stimuli (hyperalgesia). In other words, a person with central sensitization genuinely feels sensations differently and more intensely than someone without central sensitization. This enhanced response is in part due to neuroplasticity – the ability of the brain to change and adapt over time.

In chronic pain conditions, neuroplasticity actually primes the nerves to be more sensitive to stimulation, and pain signaling is not just a protective response to harmful stimuli. This means the pain is real, even if the threat is not.

Resources for Unlearning Neuroplastic Pain

The good news is that neuroplastic pain can be cured! It is pain that is learned by the brain and therefore can be unlearned.

In this section, I’ll share some of the resources that have been the most empowering for me personally in unlearning my chronic pain symptoms.

  1. Reducing fear and getting out of survival mode. This process will look different for everyone, but it is clear that high levels of fear will fuel chronic pain symptoms. For me, this meant inhibiting my pattern of pushing through uncomfortable sensations and recognizing that full-time work hours were not sustainable.
  2. Feldenkrais® Awareness Through Movement® lessons continue to support my resilience and neurological health. The novel movements explored in Feldenkrais® classes invite you into a state of curiosity, which modulates the limbic system (fear centre) and engages the prefrontal cortex (creative centre) of the brain. Reducing the level of fear you are experiencing and sending signals of safety to your brain is key to unlearning neuroplastic pain. I find that practicing Feldenkrais® consistently unwinds tension and quiets the noise in my brain and nervous system. Feldenkrais® brings my skeleton into a new organization where movement (and simply being) feels easeful and pleasurable once again. Without the Feldenkrais Method® as a reliable way to calm and regenerate my nervous system, I’d be in much worse shape – both physically and mentally.
  3. Pain Reprocessing Therapy (PRT) is a system of psychological techniques that retrains the brain to accurately interpret and respond to signals from the body, breaking the cycle of chronic pain. PRT can support you in eliminating fear-based patterns of thinking and behaving, which is the root cause of neuroplastic pain. A key aspect of PRT is attending to pain sensations through a lens of safety, rather than the fear-based lens of trying to figure out the pain and make it go away.

A practitioner trained in PRT will do a comprehensive assessment to determine whether you have neuroplastic pain and rule out nociceptive and neuropathic pain. For more information on PRT, check out the following resources:

When NOT To Do Feldenkrais®

I learned the hard way that it is not always beneficial to do Feldenkrais® when experiencing high levels of chronic pain. There are two main reasons for this.

  1. Feldenkrais® lessons are designed to improve skeletal support and movement coordination. For people with neuroplastic pain, the root cause of their pain is fear-based patterns, not poor skeletal support or mechanical inefficiency.
  2. The somatic learning that takes place in Feldenkrais® lessons requires safety – a quieting of the nervous system, a shift into a relaxed state. If your brain is on high alert due to pain signals and emotional distress, it is very difficult to relax and make sensory distinctions from a place of curiosity.

Persisting through a Feldenkrais® lesson while experiencing significant pain can also create a negative feedback loop, where you are intellectually searching for answers and movement patterns that will reduce your pain. This mindset often has underlying tones of worry, fear, and pressure that will cause your pain to persist.

I always bring it back to somatic learning in babies. What emotional affect does a baby have when it is playing on the floor and learning to move itself through space? The baby is in a state of curiosity and wonder…free of worry, pressure, and intellectual analysis. If the baby is tired, hungry, or in discomfort, it is not going to be playing and learning how to crawl. It is going to be crying in order to get its biological needs met.

I created the following guidelines for myself and my students on when to do Feldenkrais® and when not to:

  • If your pain is a 6/10 or higher, don’t do Feldenkrais®. The best thing you can do during a pain flare is absolute self-care. This might look like self-compassion, resting, or engaging in a relaxing hobby.
  • If your pain is 5/10 or lower, and you have some capacity to be curious about sensations beyond your pain, then Feldenkrais® can be very supportive and even transformative.

In closing, I hope this article inspires ongoing conversation about the concept of neuroplastic pain. I believe it is important that Feldenkrais® trainers integrate modern pain science into training programs and Feldenkrais® practitioners gain enough understanding to support students with learned pain effectively. It causes harm to treat neuroplastic pain as structural, nociceptive pain.

If you have students or family members struggling with chronic pain, I encourage you to share this article with them. If you would like to continue the conversation or share your personal experience with neuroplastic pain, please reach out to me at [email protected]

Sara Binns is a Feldenkrais® practitioner based in Buckhorn, Ontario, Canada. She graduated from the Feldenkrais Training Academy in Seattle in 2022.

Sara has also worked professionally in Indigenous health planning and systems transformation, and honours human dignity and personal agency as the foundation for learning.

On a personal level, Sara enjoys nature connection, land stewardship, hiking, dancing, and riding horses.

Due to her lived experience with chronic pain, Sara offers a compassionate and trauma-informed approach. If you struggle with chronic pain, anxiety, or discomfort doing the things you love, Sara is here to help!

Sara offers 1:1 Feldenkrais® sessions in-person and online.

To learn more, please visit:

www.somaticswithsara.com

Sara also teaches a weekly online Feldenkrais class which you can register for here:

https://stillandmovingcenter.com/2023/03/feldenkrais-with-sara-binns-online-in-studio-livestream