Chronic pain can be a life-altering experience. For many, it's not just a matter of discomfort—it affects sleep, relationships, work, and mental health. While modern medicine offers a range of treatments—from painkillers to physical therapy, chiropractic adjustments, and acupuncture—some people find little or no relief.
If you’ve tried everything and the pain still lingers, it may be time to consider a surprising possibility: the pain might not be rooted in your body, but in your mind.
This isn’t to say the pain isn’t real. On the contrary, chronic pain that has no clear physical source is very real. But increasingly, research suggests that in some cases, the brain—not the body—is the source of that pain.
The Mind-Body Connection in Chronic Pain
The brain and nervous system play a central role in how we experience pain. Pain is not just a signal from injured tissue—it’s a perception created in the brain. When there is physical damage, sensory nerves send signals to the brain, which then interprets them as pain. However, research has shown that pain can also occur without any tissue damage, or long after an injury has healed.
This phenomenon is known as central sensitization—a condition in which the central nervous system becomes hypersensitive, amplifying pain signals or even generating pain in the absence of a clear cause.
According to a 2021 review in Nature Reviews Neuroscience, central sensitization is “a key mechanism in chronic pain disorders, including fibromyalgia, irritable bowel syndrome, and chronic low back pain.”1 This means that the brain can essentially “learn” pain, creating a kind of pain memory that persists even when the body has healed.
The Role of Repressed Emotions and Psychological Stress
In the 1980s, Dr. John Sarno, a rehabilitation physician at NYU, discovered the concept that repressed emotions, especially unconscious anger and anxiety, could cause physical pain. He termed this phenomenon Tension Myoneural Syndrome (TMS). While his theory was initially controversial, it has gained traction over time as research into psychogenic pain has expanded.
Studies have since supported the idea that emotional trauma and stress can manifest as chronic pain. A 2022 randomized controlled trial published in PAIN found that pain reprocessing therapy (PRT)—a psychological treatment designed to help people reframe their beliefs about the causes of pain—led to substantial pain relief in people with chronic back pain. In fact, 66% of participants were pain-free or nearly pain-free after the treatment, compared to only 20% in a control group.
So…changing the way you think about pain—rather than changing the body—can be the key to healing.
So, How Can You Tell When The Pain May Be Psychogenic?
Not all pain is psychogenic, and it’s important to rule out medical causes first. After that, the following clues may suggest that pain is brain-driven rather than body-driven:
• No clear structural or anatomical cause on imaging such as MRI and X-ray
• Pain that moves around, rather than staying in one location
• Pain that flares up with stress or emotional upset
• Multiple failed treatments, including medications, physical therapy, chiropractic, and acupuncture
• History of trauma, anxiety, or depression
In these cases, it may be worth exploring mind-body approaches to healing, such as:
• Psychotherapy, particularly approaches like cognitive behavioral therapy (CBT) or emotional awareness and expression therapy (EAET)
• Somatic tracking and pain reprocessing therapy (PRT)
• Mindfulness-based stress reduction (MBSR)
• Journaling or expressive writing to explore underlying emotions
Another Example of the Power of the Mind
A number of years ago there was research done where a Surgeon did a sham knee replacement surgery. The surgeon actually talked as if they were doing the surgery and made some minor cuts in the skin where they would have if they had done a real surgery.
The result for many people who experienced the sham surgery was that they were pain free after the surgeon said he or she was done and that the surgery was successful!
If your pain has defied explanation and resisted treatment, it may mean that your nervous system is stuck in a loop and that it’s time to retrain your brain to find real relief!
(Reported WDDTY, April 2025)
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