BLOG 3: UNDERSTANDING CHRONIC PAIN - What modern sciencE KNOWS ABOUT PAIn

Blog
Written By Rachel Kirkbride

A shift in the conversation and why “it’s all in your head” misses the mark

At the end of BLOG 2, we began to question the idea that pain is purely physical.

This is where that conversation deepens.

Because over the past forty years, and especially in the last decade, what has been discovered by science and experts is changing how we understand pain completely.

Not just in theory, but in how it is experienced, processed and maintained in the body.

For a long time pain was seen primarily as a sign of injury or damage - something that could be found, measured and fixed.

But that explanation doesn’t always hold.

And for many people living with chronic pain, it never fully matches their reality.

A Provocative Quote Perhaps? That stayed with me…

As chronic pain expert and pioneer Dr John Sarno wrote:

“There’s nothing like a little physical pain to keep your mind off your emotional problems.”
(Healing Back Pain: The Mind-Body Connection 1991)

It’s provocative.

And perhaps it will offend some people.
Perhaps it feels like it belittles the pain you’ve been living with for years?

It doesn’t.

It’s rooted in something much deeper.

So please bear with me.

Because as someone who has lived with chronic pain for over nine years, I understand both the discomfort, and the truth, within that statement.

 

The ‘Sciency Bit’

I deliberated a lot about whether this post, about the mind and the science, should come before talking about the practical strategies I’m using to help my body mentally and physically.

And those will come, over the next few posts.

But looking back, for years I focused almost entirely on the physical. I did a little meditation, but nothing consistent.

Deep down, I knew my mind played a role.
I just didn’t fully understand how.

When I was diagnosed nine years ago, much of what we now know about chronic pain wasn’t as widely acknowledged, available or proven.

This is the explanation I wish I’d had at the start.

Because once you understand why pain behaves the way it does, everything begins to make sense.

And you can start working with your body and applying the tools to make yourself feel better, instead of constantly fighting it.

Had I understood this sooner, I truly believe my recovery would have been so much quicker and perhaps that I’d be completely pain free by now.

 

Your Body’s Alarm System

Pain Beyond the Body

Have you ever noticed your pain worsening or you get a headache when you’re stressed, overwhelmed, exhausted, or under pressure?

Or that pain that moves around the body, improves in one place, then appears somewhere else? Or flares before something you’ve been dreading?

It’s not a coincidence.

As Dr Rangan Chatterjee explains in the daily Telegraph (Sept 2025) and on his Feel Better, Live More Podcast with chronic pain expert, Dr Howard Shubiner in 2022, our bodies are wired for survival.

He uses the analogy of a gazelle being chased by a lion. It enters fight-or-flight, but once safe, it physically shakes off the stress and returns to calm.

Humans rarely do that. Our “modern lions” - deadlines, notifications, perfectionism, people-pleasing, financial worries - keep the nervous system switched on.

Muscles tighten. Breathing shortens. Digestion slows.

And pain pathways stay active, even when there’s no physical threat.

 

When Pain Becomes the Alarm

As Dr Howard Schubiner explained:

“Pain is a protector - the brain’s signal to stop, think, and take care of yourself.”

If a single pin-prick is tolerable, thousands across your body, again and again, are not.

That’s how I’ve often explained chronic pain to people: it’s not one injury. It’s your whole system reacting as if it’s under constant threat.

The nervous system flips into fight-or-flight.

And as Psychotherapist, Nicole Sachs, puts it in her book Mind Your Body: “pain becomes the alarm.”

She explains that many chronic symptoms originate from a dysregulated nervous system - one that has been living in a prolonged state of stress, or fight-or-flight, for too long.

To me, I also think about it like this: pain almost breeds more pain. The more the body hurts, the more the nervous system reacts. The more we try to suppress it, the more sensitive it can become, and/or the more we medicate, the more tolerance builds and we medicate more.

I could feel that cycle in my own body, even before I understood the science. I knew constant pain was creating more pain, like my nervous system was breaking down under the strain. The medication dulled it for a while, but it never stopped.

 

Neuroplastic Pain

What the Science Is Proving

Fibromyalgia - along with a wide range of other chronic conditions, is no longer viewed as a mystery.

As Sachs describes; these symptoms can present in many different ways from muscular and nerve pain (such as back, neck, sciatica and migraines), to digestive issues (like IBS and IBD), to autoimmune responses, tinnitus, chronic anxiety and OCD. And this list is not exhaustive.

Rather than being separate, unrelated issues, they are increasingly understood as different responses of the same underlying system.

Chronic pain specialist, Dr John Sarno originally called this Tension Myoneural Syndrome (TMS) - sometimes referred to as ‘The Mindbody Syndrome’. Today, the term more commonly used is neuroplastic pain.

Pain that arises from changes in how the brain and nervous system process signals.

The brain’s overactive protective system is doing its best to keep you safe and stays in ‘danger mode’ - continuing to sound the alarm long after the original trigger has passed.

A nervous system that has learned to keep producing pain.

 

Why this changes everything?

This is why mindfulness, emotional processing and body awareness can help.

Not just physically - but neurologically.

They help retrain the brain.

Because the brain doesn’t separate emotional stress from physical stress.

To the nervous system, it’s all input.

Which is why people with completely different symptoms: pain, stomach issues and stress-related responses - often respond to similar approaches.

Because at the core, the system is trying to feel safe again.

 

Before Assuming Your Pain is Neuroplastic

 

Before concluding your pain is neuroplastic, it’s important to rule out any underlying medical conditions.

As Nicole Sachs explains, once your doctor has ruled out causes such as cancer, infection or inflammatory disease, and you’re left with a diagnosis considered “incurable”, “it’s highly likely that nervous system dysregulation is the cause.”

This doesn’t mean the pain isn’t real. It absolutely is.
But it does suggest that what we’re dealing with may not always be structural or fully explained by a scan.

The phrase “it’s all in your head” has often been used dismissively - to suggest pain isn’t real.

But modern science tells us a more nuanced story.

Pain is always processed through the brain and nervous system - which means it is very real, even when it isn’t caused by structural damage.

And this becomes particularly clear when we look at what scans do, and don’t, show.

 

Scan findings don’t always explain pain

Even with MRI findings - a disc bulge, hip impingement, arthritic change - it doesn’t automatically explain pain.

Plenty of people have identical findings and feel no pain at all.

The difference lies in how the brain interprets those signals.

Dr Schubiner and his teams at the University of Michigan have demonstrated this clearly:

  • Two people can have the same “abnormality” on scan result, but only one feels pain

  • Those who do often show higher levels of a neurotransmitter called Substance P (which amplifies pain perception

  • The brains’ pathways can remain “switched on” without damage

So the key distinction isn’t whether something hurts
- it’s why it hurts.

Chronic pain doesn’t always mean injury.

It can mean the system has learned to stay on guard.

So no - it’s not “all in your head” in the way it’s often meant. But the brain plays a far bigger role than we once understood.

 

Where this leaves us

For a long time, I focused on what I could do physically to manage my symptoms.

It took me much longer to recognise how deeply the mind was involved - and the influence it was having on my symptoms.

I wish I had understood just how important that role really was.

Because doing so doesn’t just help you cope with or ease the pain - it opens the door to the possibility of changing it altogether.

And that possibility is what modern science is now beginning to explain.

Not just in theory, but in measurable, observable ways.

 

Next Time…

BLOG 4: THE PIONEERS BEHIND MODERN SCIENCE: FROM THEORY TO MEASURABLE PROOF


We’ll look at the pioneers behind this shift: from early ideas that were once dismissed,
to the research that is now proving how chronic pain really works -
and why understanding this is the first step before we can begin to change it.

 

Gentle Reminder: I am not a medical expert. Everything I share here and on Instagram is based on my lived experience and the practices that have helped me personally - drawing on research, literature and insights from those who are experts, who I am learning from and who I admire. The content is not a substitute for professional medical advice. Always check with your doctor or a qualified specialist, if you’re struggling, unsure about symptoms or regarding any medical condition.

References and further reading

The references and further reading below, inform this ongoing series. Those marked with a asterisk (*) are specifically referred to in Blog 3. This is not an exhaustive list, but a starting point for anyone wanting to understand chronic pain more deeply.

 

Join the wider conversation

This post is part of an ongoing series exploring Chronic Pain and the mind-body connection.
If you’d like to see the accompanying Instagram reels, or related content across Chronic Pain, Pilates and Movement, Mind-Body Wellbeing, or if you’d like to leave a comment

You can find it over on Instagram @rachel_kirkbride

 

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Rachel Kirkbride
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BLOG 2: THE BEGINNING - WHEN PAIN ENTERED MY LIFE