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How Do I Change My Relationship With My Chronic Pain?

Despite affecting around one in four adults living in the UK, chronic pain remains largely misunderstood. Chronic pain is classed as pain that has persisted for at least three months, and for many, it can totally reshape everyday life. Perhaps you’re a runner who can no longer run, or a footballer who can no longer kick a ball. It can be stressful to lose access to important outlets and hobbies, impacting not just your body but your senses of freedom and fulfilment.

Here, we’ll delve into the relationship between mental and physical dimensions of pain, exploring how perception, personal history and nervous system processes can shape your understanding of pain. Can the brain create pain even when scans show no ongoing injury? How can I improve my chronic pain?

What is chronic pain?

Chronic pain is an umbrella term that includes:

• Pain related to existing conditions such as fibromyalgia
• Pain that begins as a symptom of another condition but persists after the trigger is resolved
• Pain with no apparent physical cause

Some pain continues due to ongoing inflammation or injury. Other kinds of pain arise from direct nervous system injury, such as pain seen with conditions like diabetes, stroke or multiple sclerosis. Another category involves pain without clear tissue damage, where the nervous system has become sensitised: overly responsive to pain signals.

Pain coach Richmond Stace describes pain as a “needs state”, where pain functions less like a measurement of damage and more like a signal that something within the nervous system requires attention. Pain is your body’s alarm system ringing. When tissues are injured, signals travel to the brain to warn that something is wrong. This mechanism is protective and usually fades – with non-chronic or acute pain – as the injury heals.

Instead of asking only “where is the damage?” with respect to chronic pain, specialists are increasingly asking questions such as: “what is this pain trying to communicate?” and “why is your nervous system stuck in a protective state?”

At The London Psychiatry Centre, our goal is not just chronic pain management – but understanding why your pain in particular continues – and how long-lasting change becomes possible through compassionate, collaborative and tailored approaches. We understand that the deepest distress caused by pain isn’t always the physical sensation itself, but the loss of the life you imagined.

Can the brain create pain even when there is no physical cause?

To put it plainly, yes. Pain is an experience, not simply a signal of damage. Pain is constructed by the brain after interpreting information from many different sources: sensory input from your body like a cut or sprain, but also past experiences, your emotional states, expectations, and fears.

So, if your injury has healed, or if you were never injured, why does it hurt? And what does chronic pain do to your body? There are several potential answers to these questions, depending on you and your individual circumstances.

Pain science is increasingly recognising that the body’s pain response is triggered and sensitised not only by injury but also by broader lived experience. This can include feeling misunderstood or unsafe in consultations with your clinicians, a history of trauma or high stress levels, sleep disturbance, or cycles of fear and avoidance of movement.

Pain becomes persistent due to an underlying change in the brain that we call central sensitisation: when the nervous system becomes increasingly responsive to pain signals. This is often referred to as “neuroplastic pain,” where learned pain pathways persist even after injuries heal – but it can also be reversed over time.

The gap between what is felt and what is seen is often where better questions need to be asked.

How does chronic pain affect your body?

Stress and trauma are significant influences on the body’s pain system, with chronic pain representing a form of sustained stress in itself. Sustained stress from chronic discomfort can keep the body in a heightened state of alert, increasing the chance that everyday pain sensations will be interpreted as danger by the nervous system, further damaging quality of life.

Psychological factors such as fear, expectation and avoidance behaviours can account for large proportions of pain-related disability. When pain occurs during movement, you understandably begin to avoid that activity. Over time, this reinforces neural pathways, making pain feel more persistent.

Many modern approaches to pain management focus not only on reducing pain signals but on more general nervous system regulation: by increasing a felt sense of safety in your body.

Safety is something that can be built over time, through trusting relationships with clinicians who can carefully tailor a blend of approaches to your pain to regain the life that excites you.

At The London Psychiatry Centre, we examine neurological, psychological, and behavioural influences together. Our specialists deliver a personalised and whole-person model of care to effectively treat individuals with conditions like fibromyalgia, migraine and selected neuropathic pain conditions, combining treatments such as rTMS with lifestyle medicine.

Is there treatment for pain with no physical cause?

Once pain becomes persistent, the focus often shifts from eliminating it to changing how you respond to it over time. If the pain can be alleviated, this is ideal of course. Guidance from National Institute for Health and Care Excellence highlights the importance of self-management, autonomy and consistency in learning to deal with chronic pain.

The clinician–patient relationship is central to treating chronic pain. Feeling heard, believed and treated with genuine compassion is not incidental to recovery; compassion and understanding can directly reduce perceived threat and influence pain levels.

When the nervous system begins experiencing regulation again, your brain’s predictions surrounding pain can gradually change. Emerging approaches such as Pain Reprocessing Therapy (PRT) build on this principle, helping patients reinterpret pain signals as non-threatening. Key components of PRT include mindfulness practices which create positive associations with uncomfortable bodily experiences.

Clinical trials on PRT demonstrate meaningful reductions in chronic pain through these changes in perception. Dr Deepak Ravindran, Consultant in Pain and Lifestyle Medicine, comments that for a “category of patients where the nervous system oversensitivity can be present due to emotional stress and neural circuit changes…Pain Reprocessing Therapy promises to be a potentially really helpful option in reversing symptoms and pain significantly”.

There are also medical interventions available. In some cases, medications, nerve-modulating drugs or targeted injections can provide relief from chronic pain and create space for meaningful recovery. For some people, an initial reduction in pain intensity through steroid injections, for example, is what allows long-term progress to begin.

RTMS in particular has been shown to be beneficial for those with certain pain conditions, such as fibromyalgia.

How do I deal with chronic pain?

Managing movement

Reintroducing meaningful activity in small, manageable ways helps rebuild confidence – for example, seated or supported movements or yoga. Finding a support system to hold you accountable on this journey can be helpful, to remind you how important each step forwards – and each step backwards – can be.

Mind-body relaxation

Alongside low-impact body work, mind-body techniques such as breathing exercises, guided meditations that focus on bodily awareness, gentle movement, or massage can help signal safety to the nervous system.

Consistent routines

Maintaining stable routines, balanced nutrition and regular sleep-wake timing can contribute to a more predictable internal environment. In particular, nutrition plans that support the immune system and reduce inflammation – such as the adoption of broadly anti-inflammatory diets can play a supportive role in calming the overall system, even when inflammation is not clearly visible on scans.

Pacing

One of the most common patterns in chronic pain is the ‘all or nothing’ cycle, which involves doing too much on good days, followed by flare-ups and withdrawal. Focussing on creating a steady, sustainable baseline of activity and expectation helps stabilise your system.

Sitting with discomfort and practicing gratitude

Another shift is learning to separate sensation from interpretation. Not every signal requires an immediate response. Even a brief pause can reduce intensity. Pain coaching can be beneficial here, also offering opportunities for meaningful mindset development. For example, even changing your use of language through positive self-talk, or coming to find a place for pain in your life, can be deeply empowering.

Change is not always immediate or linear. But consistent, conscious, day-to-day changes are often what allow your system to start settling, and reveal the light at the end of the tunnel. The dedicated pain clinic service at The London Psychiatry Centre aims to apply these principles in practice to help you regain a life that you’re excited about living.

Contact our team on 020 7580 4224 or info@psychiatrycentre.co.uk for more information or to book a consultation.