🧠 When Pain Won’t Switch Off: Understanding Chronic Pain

🧠 When Pain Won’t Switch Off: Understanding Chronic Pain

About the Author

Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation.

He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches.

His treatment focus includes:

• Chiropractic adjustments

• Sports chiropractic

• Massage therapy

• Shockwave therapy

• Laser therapy

• Non-surgical spinal decompression

Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions.

Pain. We’ve all felt it.

Stub your toe? Ouch. Touch a hot stove? Pull away fast.

That’s normal pain — your body’s alarm system doing its job.

But what happens when the alarm keeps ringing… even after the danger is gone?

Welcome to the world of chronic pain, and more specifically, conditions like:

• Neuropathic Pain (NP)

• Complex Regional Pain Syndrome (CRPS)

• Central Sensitisation (CS)

• Fibromyalgia (FM)

At Health Wise Chiropractic, we see many patients who feel frustrated because their scans look “normal” — but their pain is very real.

Let’s break this down in a way that makes sense 👇

🔥 Pain: It’s Not Just About Tissue Damage

Pain is defined as an unpleasant sensory and emotional experience.

Normally, it protects us.

But in chronic pain, the nervous system can become overprotective — like a smoke alarm that goes off when you make toast.

This is called central sensitization — when the brain and spinal cord amplify pain signals.

And here’s the kicker:

👉 Pain without visible injury is still 100% real.

📊 The Scale of the Problem

Chronic pain is one of the largest global health burdens.

Some powerful stats:

• 6–10% of the general population experiences centralized pain.

• Neuropathic pain affects anywhere from 0.9% to 20% of people.

• Fibromyalgia affects between 0.2% and 11% of the population — most commonly women.

• CRPS occurs in approximately 5.5–26.2 cases per 100,000 people per year.

• In CRPS, 31% of people are not back at work 2 years after onset.

• About 15% of CRPS patients still have severe symptoms two years later.

That’s not minor discomfort.That’s life-altering pain.

⚡ What Is Neuropathic Pain?

Neuropathic pain happens when the nervous system itself is injured or malfunctioning.

Instead of responding to damage, it creates pain.

Symptoms often include:

• Burning

• Electric shock sensations

• Pins and needles

• Hypersensitivity (allodynia)

• Pain from light touch

Unlike normal pain, it doesn’t switch off easily — and many treatments only provide partial relief.

🌀 Complex Regional Pain Syndrome (CRPS)

CRPS is one of the most severe forms of neuropathic pain.

It often starts after a minor injury — but the pain becomes far greater than expected.

It can involve:

• Temperature changes

• Skin color changes

• Swelling

• Movement restriction

• Severe burning pain

Diagnosis is difficult. There’s no single definitive test.

And the impact?Significant reduction in quality of life and increased mental health risks.

🌪 Central Sensitization: When the Volume Knob Is Turned Up

In central sensitization:

• The nervous system becomes hypersensitive.

• Light, sound, temperature — even gentle touch — can feel painful.

• The body’s internal pain brakes don’t work properly.

It’s often associated with:

• Fatigue

• Brain fog

• Sleep disturbances

• Anxiety or depression

• Heightened stress responses

This is why chronic pain isn’t just physical — it’s neurological and multisystem.

💫 Fibromyalgia: More Than “Just Pain”

Fibromyalgia is a widespread pain condition with:

• Chronic pain

• Fatigue

• Poor sleep

• Cognitive difficulties (“fibro fog”)

• Balance issues

• Higher fall risk

Muscle strength in fibromyalgia patients can be up to 35% lower than healthy individuals.

And yet — there are no clear blood tests or imaging markers.

That doesn’t mean it’s not real.

It means the nervous system is involved.

💊 Do Medications Solve It?

Medications are often used — including:

• Anti-inflammatories

• Antidepressants (SSRI/SNRI)

• Anticonvulsants

• Gabapentinoids

• Opioids

• Monoclonal antibodies (for migraine)

• Cannabinoids

But here’s the reality:

• Most provide modest improvements at best

• Side effects are common

• Opioids can actually increase pain sensitivity long-term (opioid-induced hyperalgesia)

• Many patients never achieve complete relief with medication alone

That’s why modern pain science emphasizes a multidisciplinary approach.

🏃‍♂️ The Most Powerful Tool? Movement.

Exercise is one of the most evidence-supported treatments for fibromyalgia and chronic pain.

Research shows exercise can:

• Improve strength

• Reduce pain

• Improve balance

• Increase serotonin (5-HT)

• Boost natural opioid pathways

• Improve heart rate variability

• Reduce fear of movement

Even home-based exercise programs and exergaming showed measurable improvements over 20–24 weeks.

And when proprioception training was added?Balance, fatigue, and quality of life improved significantly.

Movement retrains the nervous system.

🧘‍♀️ The Mind–Body Connection

Chronic pain is closely linked to:

• Catastrophizing

• Hypervigilance

• Anxiety

• Depression

• Poor sleep

Cognitive Behavioural Therapy (CBT) is considered one of the most effective psychological treatments for chronic pain.

Importantly:

Seeing a psychologist does NOT mean your pain is “in your head.”

It means your nervous system is involved.

👐 What About Hands-On Care?

Manual therapy and gentle touch can activate special nerve fibres (C-tactile fibres) linked to:

• Oxytocin release

• Limbic system calming

• Reduced wind-up pain responses

Gentle touch at specific speeds (around 10 cm/sec) has been shown to reduce pain more effectively than neutral touch.

Pain modulation is neurobiological — not just mechanical.

🥗 Nutrition Matters Too

Evidence suggests:

• Mediterranean-style diets support brain health

• Obesity worsens fibromyalgia and migraine outcomes

• Vitamin B12 may support neuropathic pain

• Vitamin E deficiency can cause neuropathy

• Antioxidants may support neuroinflammation control

The gut microbiome also influences serotonin and GABA — both key in pain regulation.

Pain care is bigger than just muscles and joints.

🧲 Emerging Therapies

Research is exploring:

• Transcranial magnetic stimulation (TMS)

• Transcutaneous electrical nerve stimulation (TENS)

• Photobiomodulation (laser therapy)

• Vibration therapy

• Vagal nerve stimulation

• Mirror therapy and motor imagery

Some show promise. Most show modest benefits. All reinforce one key theme:

🧠 The brain is central to chronic pain.

💡 So What Does This Mean For You?

If you’re living with persistent pain and feel:

• Dismissed

• Confused

• Frustrated

• “Nothing shows up on scans”

Please hear this:

👉 Your pain is real.👉 Your nervous system may be stuck in protection mode.👉 There are ways to retrain it.

At Health Wise Chiropractic, we take a biopsychosocial approach — looking at:

• Movement patterns

• Nervous system regulation

• Stress load

• Lifestyle

• Exercise prescription

• Gentle manual therapy

• Collaborative care when needed

Because chronic pain isn’t just a tissue problem.

It’s a system problem.

And systems can be retrained.

https://youtube.com/shorts/GnMn_zRHUUE

Neck Pain Chiropractor

Q: What causes neck pain that chiropractors treat?Common causes include poor posture, desk work, whiplash, and muscle tension.

Q: How does chiropractic care relieve neck pain?Through gentle spinal adjustments, soft tissue therapy, and posture correction.

Q: Is it safe to adjust the neck?Yes, when performed by a qualified chiropractor, neck adjustments are safe and effective.

Q: Can chiropractic help with tech neck?Absolutely — chiropractic care can ease strain from long hours at computers or devices.

https://video.wixstatic.com/video/36c99a_f3069768cca44dd89d7ad22549386c0b/720p/mp4/file.mp4

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Quodling N, Hoffman N, Carrick FR, Jemni M. Beyond the Pain: Rethinking Chronic Pain Management Through Integrated Therapeutic Approaches-A Systematic Review. Int J Mol Sci. 2026 Jan 26;27(3):1231. doi: 10.3390/ijms27031231. PMID: 41683658; PMCID: PMC12897678.