What to Know About Nociplastic (Neuroplastic) Pain

• Definition of Nociplastic (also known as Neuroplastic) Pain

  
  

  • Nociplastic pain is pain that arises from altered nociception

    • Nociception is the physiological process by which the nervous system detects and processes harmful stimuli, like heat, cold, or physical injury, to protect the body. This is the automatic process that detects potential damage and sends that signal to the brain.

      
      

• Pain is a danger signal. But not a perfect one.

• If you put your hand on a hot stove, the brain gets signals from your hand, then creates the sensation of pain which tells you to move your hand so you don’t injure yourself further.

• But in some cases, the danger signals and subsequently the perception of pain can get activated in the brain even in the absence of structural damage or disease in the body. So what is going on there?

• The brain can learn to interpret bodily sensations as if they are dangerous. Even in the absence of true physical danger.

• It’s like if I tossed you a baseball but your brain thought it was a hand grenade. It would respond as if it were dangerous and your fight or flight system would get activated immediately.

• A brain can learn to interpret sensations as dangerous and the result of this is that the brain amplifies that sensation.

  • It turns up the volume and tries to get your attention.

  • If a sensation is deemed dangerous or threatening the brain can create pain.

• How we respond to bodily sensations, such as how we think and feel about them and our expectations of those sensations, can inform the brain of whether something is dangerous and how to respond to it.

• When we say dangerous we don’t just mean the usual ideas of physical danger but also dangerous to our way of life, to our self-esteem, to our mental health, to our finances or our relationships. Pain sensations can feel dangerous if it starts getting in the way.

• This type of brain learning in regard to physical sensations can occur in chronic pain conditions as well as other chronic illnesses.

• This learning occurs without the person meaning to and is a function of how the brain works at times.

• Not all pain is neuroplastic (learned). There are many other types of pain.

• But neuroplastic pain can be a component or a portion of many health conditions that have pain related symptomology.

• So it is worth it to try to treat neuroplastic pain as it is noninvasive, doesn’t involve medications or surgeries, and a person can learn to manage that type of pain on their own which can increase self-efficacy.

• Pain is complex.

• Some of a persons pain may be acute pain or neuropathic pain while other parts could be neuroplastic. Neuroplastic pain doesn’t tend to respond to traditional medical treatment.

• Because pain is complex, treatment of pain should likely include numerous approaches and be multidisciplinary.

• We should not ignore our bodies and decline to seek out proper treatment just because a piece of our experience could be neuroplastic.

• We should engage in treatments and assess what’s going on at all levels, biologically, psychologically and socially (impact of pain on life). Treating persistent pain is often multifactorial meaning we should have multiple different interventions in our treatment plan. Addressing neuroplastic pain or the ways in which how we think, behave, feel and interact with pain is just one piece of it.

If you have questions, or are interested in working on this type of pain, please reach out!

Megan Hunsaker, PhD

Licensed Psychologist