Pain is frustrating.

Whether you’re an athlete or just trying to get through your day, chronic pain can be nagging, depressing, and debilitating. But what if I told you your pain might not be 100% biological? What if there was something you could do unrelated to traditional physical rehab that could decrease or eliminate your pain? Would you do it?

Anatomy, physiology, and pathoanatomy are one part of pain science, known as the biomedical approach. These factors need to be treated as such: one part of the puzzle.

Research is showing that a new model of chronic pain management known as the biopsychosocial approach is taking over, and the results speak for themselves. This approach encompasses psychological components such as thoughts, emotions, behaviors, as well as social factors and their dramatic influence on the nervous system.

Injury, disease, pain, threat and emotions are processed by the nervous system, and this approach educates patients on the understanding of how.

Sports performance is an output of the brain. By honing in on skill through endless repetition, neural pathways are strengthened to develop these skills. Repetitive practice of any task will thereby enhance the neural map of said task.

The excitatory neurotransmitter, Dopamine, has a role in solidifying these connections.

A technically solid snatch or clean and jerk, a seamless baseball pitch, and a refined jump shot all occur through the same process. Unfortunately, this same process can occur in a negative way, it’s called pain.

Patients who continually worry, obsess, or anticipate pain are unknowingly reinforcing these negative neural pathways to – yes – create more pain. These thoughts and actions, positive or negative, repeatedly stimulate neurotransmitters like Dopamine to create this process. Similar connections are made in addictive behavior like drug abuse, explaining why changing these thoughts and actions can be so difficult.

Nociception is defined as the sensory nervous system’s response to harmful or potentially harmful stimuli.

If the vital areas of the brain are preoccupied with processing this negative information 24/7, you can imagine why it may be difficult to perform routine daily activity at optimal capacity.

This is especially true for in depth motor control tasks involved in athletic performance.

Education on this topic is the first step to recovery. Understanding that physical tissue injury may not be the sole source of your pain is important; mobilization/manipulation, exercise, and modalities may only get you so far. Multiple approaches may be necessary to encompass a full recovery.

If chronic pain is disturbing your quality of life, physical performance, or even your income, consider the psychological effect of the nervous system, and ask your physical therapist to talk to you about pain neuroscience education. (Hint: If they can’t, find yourself a new physical therapist).

Learn more by contacting Pure Physio and scheduling an appointment.

Puentedura, E. J., & Louw, A. (2012). A neuroscience approach to managing athletes with low back pain. Physical Therapy in Sport, (3), 123. Retrieved from