Is My Pain Neuroplastic? 12 Signs to Look For
If you live with chronic pain or other lingering symptoms, you may be asking: "Is my pain neuroplastic?" Here's how to start answering it.
First, What Is Neuroplastic Pain?
Neuroplastic pain is pain that your brain generates because it has learned to read safe signals from the body as dangerous. The Pain Reprocessing Therapy Center describes it this way: the pain is real, but the cause is learned neural pathways, not tissue damage.
That's the hopeful part. What the brain has learned, it can unlearn.
The research behind this is strong. In a 2022 randomized clinical trial published in JAMA Psychiatry, adults with chronic back pain received four weeks of Pain Reprocessing Therapy. Afterward, 66% of the PRT group were pain-free or nearly pain-free (a 0 or 1 out of 10), compared with 20% of the placebo group and 10% of the usual-care group. Most of those gains held at the one-year follow-up.
Safety First: Rule Out Medical Causes
Before anything else, please see a doctor to rule out structural or medical causes of your symptoms. Neuroplastic pain is identified after those have been checked, not instead of checking.
Seek prompt medical care if you have any red flags, such as:
Fever or signs of infection
Unexplained weight loss
New neurological symptoms, such as weakness, loss of bladder or bowel control, or numbness that keeps getting worse
Pain after a fall, accident, or other trauma
This post is for education only. It isn't a diagnosis or medical care, and it doesn't replace your doctor.
The Signs: A Checklist
Dr. Howard Schubiner, author of Unlearn Your Pain, groups the clues into three families: symptoms that are Functional (they don't fit a structural problem), Inconsistent (they vary in ways a structural problem wouldn't), and Triggered (they're set off by things that couldn't physically cause them). Alan Gordon, who created PRT, lists similar guidelines in his book The Way Out.
You don't need to check every box. Even a few can be meaningful. Read through and notice which ones sound familiar.
How Your Pain Started
☐ It began without an injury. The pain showed up on its own, or from something minor that shouldn't have caused lasting trouble.
☐ It began during a stressful time. A move, a loss, a hard job, a relationship strain, or a stretch of caregiving.
☐ It lasted past normal healing time. You had a real injury, but the pain kept going long after the tissue should have healed (Dr. Schubiner notes roughly three to six months).
How Your Pain Behaves
☐ It's inconsistent. Some days sitting hurts and some days it doesn't. The pattern never quite holds up when you look closely.
☐ It spreads or moves. Pain starts in one place and travels, or it jumps from your neck to your back to your hip over time.
☐ It shows up on both sides. Symmetrical symptoms, like both wrists or both knees, without an injury to both.
☐ It fades when you're absorbed or happy. It's quieter on vacation, during a good conversation, or when you're caught up in something you love.
☐ It comes after activity, not during. You feel fine on the walk, then hurt that evening or the next morning.
What Sets It Off
☐ Stress or emotions trigger it. It flares before a hard meeting, a family visit, or a doctor's appointment, sometimes just from thinking about it.
☐ Things that can't physically cause pain trigger it. Weather changes, time of day, certain sounds, light, or smells.
Your Bigger Health Picture
☐ You've had many symptoms over your lifetime. Headaches, IBS, back or neck pain, pelvic pain, fatigue, insomnia, or anxiety, often coming and going over the years. Gordon points out that it's unlikely to have three or more unrelated physical conditions unless neuroplastic pain is behind at least some of them.
☐ Tests don't explain it. Your imaging is normal, or it shows "wear and tear" that doctors can't clearly link to your pain.
A Word About Imaging
This one deserves its own note, because scan results can be so frightening. A large 2015 review in the American Journal of Neuroradiology looked at spine imaging in more than 3,000 people who had no back pain at all. Disc degeneration showed up in 37% of 20-year-olds and 96% of 80-year-olds. Disc bulges showed up in 30% of 20-year-olds and 84% of 80-year-olds.
In other words, many findings on a scan are a normal part of aging, like gray hair on the inside. They don't automatically explain your pain.
Personality and Life History Matter Too
Both Schubiner and Gordon point to some patterns in a person's history and personality that can keep the brain on high alert:
Childhood adversity. Abuse, neglect, a parent who struggled with illness or addiction, or simply growing up feeling unsafe.
Inner pressure. Perfectionism, people-pleasing, self-criticism, worry, and a strong sense of duty to everyone but yourself.
If you're reading this and thinking, "That's me," you're in good company. These traits are common in kind, conscientious people. They aren't flaws. They're ways of coping that once kept you safe, and your nervous system may still be working overtime because of them.
What If Many of These Sound Like You?
First, take a breath. Recognizing neuroplastic pain is often the first real step toward feeling better, because it means your body isn't broken. Your brain has learned a danger signal that it can learn to turn down.
Pain Reprocessing Therapy helps you do that. It involves gathering evidence that your pain is neuroplastic, practicing somatic tracking (paying attention to sensations with curiosity and safety instead of fear), and gently retraining how your brain responds to them.
— Dr. Christine Williams, PhD
This article is for educational purposes only and isn't medical advice, diagnosis, or treatment. Always talk with your doctor about new or changing symptoms.
References
Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(1):13-23. doi:10.1001/jamapsychiatry.2021.2669
Schubiner H, Betzold M. Unlearn Your Pain: A 28-Day Process to Reprogram Your Brain. 3rd ed. Mind Body Publishing; 2016.
Schubiner H. Chronic Pain (webcast slides: Functional, Inconsistent, Triggered criteria). Optum Health Education; 2019.
Gordon A, Ziv A. The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain. Avery; 2021.
Pain Reprocessing Therapy Center. "Most chronic pain is neuroplastic." painreprocessingtherapy.com. Accessed October 2026.
Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173
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