What is chronic pain?
Today we’re going to talk about chronic pain and hopefully give you some insight into why pain occurs and why it persists.
Lets start by learning: what is pain?
Pain is defined by the International Association for the Study of Pain as:
“An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
This is important because it highlights something many people are never explained: pain is not just a signal from damaged tissues. It is an experience created by the brain and nervous system, influenced by a combination of physical, emotional, and social factors.
What is chronic or persistent pain?
Pain is often described as “chronic” or “persistent” when it lasts longer than about 3 months, or beyond expected tissue healing time after an injury.
However, this label can sometimes be misleading, as it may imply ongoing damage when that is often not the case.
Pain does not always mean harm
Pain is not a direct measure of tissue damage. It is more accurately a measure of perceived threat, designed to protect you from further harm.
This is where your nervous system comes in. Your nervous system is your body’s communication network. It includes your brain, spinal cord, and all the nerves that carry messages between your body and brain. It constantly monitors what is happening inside and outside your body and decides how “safe or unsafe” things feel. Pain is one of its protective outputs.
Why does pain become persistent?
When pain continues beyond normal healing time, the nervous system can become more reactive and produce pain at a lower threshold—similar to an alarm system that becomes overly sensitive.
Imagine a smoke alarm that goes off not only for fire, but also for toast, steam, or a hot shower. It is still working correctly, just oversensitive to a perceived threat.
This can help explain why people can experience:
Pain that feels “out of proportion” to scans
Pain that flares without a clear injury
Good and bad days with no clear structural change
Pain that spreads or changes over time
Worse pain when we are stressed or tired
Importantly, this does not mean pain is “in your head.” It means the nervous system has likely become more protective and sensitive.
The good news
One of the most important findings in modern pain science is neuroplasticity—the nervous system’s ability to change over time.
Just as pain pathways can become more sensitive, they can also become less reactive with the right support, input, and time.
This is why recovery is often less about “fixing a structure” and more about helping the nervous system feel safe again.
Treatment often focuses on:
Down regulating our heightened nervous system
Reducing strain and tension in the body
Rebuilding confidence in the body
Improving sleep and recovery
Stress regulation strategies
Education about pain and the nervous system
Reducing fear around movement
Reframing our pain
If any of this has resonated with you, I encourage you to start small by reframing your pain. Instead of “chronic pain,” we can use the term persistent pain.
Why? Because language matters. “Chronic” can feel fixed or hopeless, while “persistent” acknowledges the pain has been ongoing—but also that change is still possible.
Similarly, shifting language from “trauma” to “tissue injury” or “tissue sensitivity” can sometimes reduce fear and change how the nervous system interprets threat.
These small shifts can be a powerful first step in improving our pain experience.
How osteopathy can help
Osteopathy can support people with persistent pain by taking a holistic approach. Rather than focusing only on the area of pain, treatment considers how the whole body is moving and functioning, as well as how stress, sleep, posture, and daily load may be contributing.
Hands-on treatment may help reduce tension, improve movement, and provide a sense of ease in the body, while rehabilitation and education help restore confidence and guide gradual return to normal activity. Importantly, osteopathy aims to support the nervous system in reducing sensitivity and improving how the body processes daily stress and load.
Additional resources
If you’d like to learn more about pain science and understanding your pain:
Podcasts about pain: The Lorimer Moseley Podcast: Pain Matters, Tell Me About Your Pain (Curable Health)
Psychologists interested in pain science, mindfulness CBT