How to Rewire the Nervous System to Heal Pain
The medical model treats pain as a structural problem. Diagnostic imaging is used to identify damage to the tissues, and interventions are focused on repairing the damage and restoring physical function.
While this is helpful when you have an acute injury, this approach does not actually treat pain directly, and it is ineffective at treating chronic pain, which is not a structural issue.
Pain is an output of the nervous system, not an input from the tissues.
More specifically, pain is sensation plus fear.
The nervous system’s main job is to keep you safe. If the nervous system believes that your environment might be dangerous, it will alert you by generating pain.
Chronic pain is caused by prolonged sensory input that the nervous system interprets as dangerous. If the perception of threat persists, the nervous system becomes hypervigilant and sensitive to sensation, activating the pain alarm even when there isn’t any danger. This is akin to a fire alarm that malfunctions and activates when there isn’t any heat, smoke, or fire.
How the Nervous System Makes Decisions
The nervous system has a three-step process to decide how to act:
Input
Interpretation
Output
First, the nervous system gathers sensory information through:
Exteroception (the five senses)
Interoception (sensory cues from inside the body)
Vestibular information
Proprioception (like the body's GPS that tells the central nervous system where our body is in space)
Then, the nervous system assesses that information for safety.
Based on the information it receives from the internal and external environments, and the way the nervous system interprets that information, it responds on a spectrum from presence to protection.
When the inputs the nervous system receives are interpreted as threatening, the outputs are defensive and protective. Over time, the nervous system can become hypervigilant and can start to interpret even safe sensory signals as dangerous. This can manifest as the following outputs:
Chronic pain
Chronic fatigue
Migraines or frequent headaches
IBS or other digestive challenges
Chronic conditions, such as long Covid and chronic Lyme
Sleep disturbances, insomnia, or nightmares
Anxiety, worry, or fear
Heart palpitations or racing
Depression or hopelessness
Irritability, impatience, anger, and reactivity
Being easily overwhelmed
Feeling depleted
Being wired, but tired
Brain fog or confusion
Trouble concentrating
Difficulties with executive functioning
Memory challenges
Racing thoughts
Most treatments focus on changing the outputs, which is why they often don't work. For example, when the nervous system interprets movement as dangerous, it will guard and limit mobility. Treatments that focus on enhancing range of motion may work temporarily, but they often don't provide lasting relief, and sometimes they even make the pain worse by increasing the sensory input the nervous system receives from a part of the body it is protecting.
Lasting nervous system change happens when we change the inputs and the way we perceive them. By focusing on these root causes, the outputs change naturally, and sustainably.
How the Nervous System Generates Pain
The same three-step process the nervous system uses to assess and respond to the environment is used to produce pain:
The nervous system receives sensory input from the body.
The nervous system processes that information to determine whether it is dangerous or safe.
If the nervous system detects a potential threat, it sends an output signal in the form of pain*.
(*The output can manifest as physical pain, digestive issues, anxiety, sleep disturbance, brain fog, executive dysfunction, overwhelm, etc.)
When we experience long-term pain, the nervous system becomes sensitive and starts to send more sensory input up to the central nervous system for review. At the same time, the nervous system becomes more fearful of the information it is receiving, and more likely to interpret it as dangerous. This increases the output of pain, and becomes a self-reinforcing cycle.
Reduce Pain by Rewiring the Nervous System
Most treatments for pain focus on the output, which may provide temporary relief, but it is much more effective in the long term to treat pain by changing the input and processing.
Here is the basic formula for treating the root causes of pain:
Step 1: Change the Input
Replace danger cues with safety cues.
Interrupt the pain pathway with novel and positive sensory input.
Step 2: Change the interpretation
Reduce sensitivity and vigilance.
Deepen presence and build the capacity to experience sensation without fear.
Step 3: The outputs change organically
Pain equals sensation plus fear.
When the nervous system feels safe again, it no longer has to sound the pain alarm.
If you’ve tried the structural, orthopedic approach to treating your pain and it has not resolved your problem, it is not because your body is broken, it is because your treatments were focused on the outputs, not the inputs or root causes.
Whether your pain is structural (nociceptive), nerve-related (neuropathic), or the result of central sensitization (neuroplastic), teaching the nervous system to feel safe and building your capacity to experience sensation without fear is essential to addressing pain directly.
Rewiring the Nervous System Case Study
So what does that actually look like in real life? This is an example from a client who we'll call Erika (story used with permission).
Don't worry, this story has a happy ending.
Erika had back pain for over 20 years. When we met, she told me that she didn't remember the last time she had a pain-free day.
Sometimes her pain was so bad that she wasn't able to work. It had cost her jobs and relationships, and deeply impacted her mental and emotional health.
Erika was so afraid of making the pain worse that she limited her activity and stopped doing most of the things she loved. She was reluctant to make plans with friends, and her world became smaller and smaller until she was pretty isolated.
She had been seeing a chiropractor for years. She tried orthopedic physical therapy, massage, injections, and medication. She was considering having surgery because nothing else was working.
Erika took my pain program, and by the end of the course, she had stopped taking medication, gone back to work, and started exercising regularly. Erika had consistent pain-free days for the first time in decades. Pain no longer controls her life.
Here's how she regained her freedom:
For years, every time she felt a sensation in her back, Erika was terrified that she had damaged something. When she realized that pain is an output, not an input, she stopped being afraid of the pain. She points to this shift in consciousness as being the most important point in her healing journey.
Erika did an audit of her daily activities and realized that so many of the things she was doing to avoid pain were sending danger cues to her nervous system. She made an intentional choice to prioritize rest and nourishment, and to help her nervous system feel safe again.
After experimenting with different neurosomatic practices, she found two sensory practices that were effective at reducing pain in the moment and in creating a new sensory pathway. The first was humming while gently stimulating the auricular branch of the vagus nerve in her ear. The second was practicing abhyanga, which is an Ayurvedic self-massage practice. She found the oil to be grounding and nourishing, and the healing touch helped her redevelop a positive relationship with her body. She did these practices regularly to provide positive sensory input to her nervous system.
In the pain program, Erika learned how to be present with sensation without fear using a combination of somatic exercises and yoga practices, such as body scans and alternate nostril breathing. Now when she feels a sensation in her back, she doesn't freak out. She knows that sensation is just a sensation, and she is able to experience it with presence and not protection.
Erika's pain was activated by movement. Gradually, Erika started reintroducing gentle movement in a safe container. She was prepared for sensation to increase when she increased her activity because her nervous system was sensitive to movement, so she practiced pacing, and she used her new tools to help her increase her tolerance and slowly build back her activity.
Erika's back X-rays still show arthritis and degenerative changes, but she no longer has debilitating pain. We didn't treat the structure of her body at all, but we did change the inputs and her relationship to the pain, which decreased her perception of threat and turned down the volume of the pain alarm so significantly that she was able to regain control of her life.
Ways to Work with Me
If you are struggling with pain, I'd love to teach you help you:
Orient to to safety;
Accurately interpret your sensory experience
Build your capacity to respond from a place of presence rather than protection.
I offer 1:1 and small group programs virtually and in Shelburne, VT to guide you through the process of rewiring your nervous system to transform:
Vigilance into presence
Fear into safety
Defensiveness into resilience
If you are curious about working together 1:1 or joining the Break the Pain Cycle program, please schedule a free Nervous System Attunement Strategy Session. You'll get clear on what your nervous system needs and what is keeping you stuck, and we can develop a customized plan to get you the support you need.
