What Causes Chronic Pain When There Is No Injury?

Or, what causes chronic pain if there is an injury that has healed as much as it is going to?

This is the third of a series of short blogs on different aspects of new thinking on managing chronic pain. It is influenced by research on the effect of neuroplasticity, my own experiences of living with and resolving chronic pain caused by an L5 back injury and those of my clients.

Initially we experience pain, and it is acute pain and we expect it to clear, and then it doesn't. What is happening to cause that? The first thought was “Something is hurting, so something must still be damaged.”

For some time pain science research shows it is more complicated than tissue damage. Pain is produced by the nervous system from many sources of information. Tissue damage matters, but so do previous experiences, expectations, threat and attention. This helps explain why people with similar physical findings can experience very different levels of pain -  and why pain can sometimes continue when there is no clear ongoing tissue problem that explain the symptoms.

That doesn’t mean the pain isn’t real. It just means the pain comes from a variety of sources, not just simply our injury.

In my own example, I have an injury that is still detectable on a back scan. One way I have created changes by reducing tension in the muscles which had learned to guard the injury. Knowing that pain was more complicated than damage gave me a great opportunity to have an influence over what happens next.