Rewiring the Brain — Recovery from Pain and Other Persistent Symptoms

Neuroplastic pain (known in medical terminology as Nociplastic pain) is pain that doesn't originate in structural damage to the body's tissues, but in learned changes in the brain and central nervous system. Current neuroscience holds that all pain is produced in the brain, and that its purpose is protection — a response to what the brain reads as danger to the body. And contrary to common belief, pain isn't necessarily a reliable measure of physical damage; it reflects more the level of 'danger' the nervous system senses, often unconsciously. For instance, studies show a weak correlation between various imaging findings (such as CT, MRI, and ultrasound) and the actual pain.

In most cases of chronic pain (defined as pain lasting beyond 3–6 months) the pain is essentially neuroplastic — that is, the brain's 'danger mechanism' keeps operating long after the tissue has healed, and sometimes without any initial injury at all. The more the brain's pain pathways are activated again and again, the stronger they become — like a 'speed dial' the brain learns to trigger more easily — and the system grows more sensitive, causing pain to flare even from gentle movements or stimuli. This can create a vicious cycle, in which the fear of the pain and our negative reaction to it — amplify it over time. In such cases, treatments aimed only at the body (medication, surgery, physiotherapy, chiropractic) or only at the mind (psychotherapy) often aren't effective enough on their own, and a combined approach — one that addresses the brain and nervous system — is needed.

The diagnosis rests on two complementary axes:

First — Ruling out a structural cause: making sure there's no other serious medical cause for the pain (such as a fracture, tumor, infection, or nerve damage) that requires different treatment. Usually, patients with persistent pain have already seen several specialists, had many scans and tests, and no structural cause was found to explain their symptoms. Nevertheless, before starting neuroplastic treatment, sometimes additional medical evaluation is needed.

Second — Identifying neuroplastic pain patterns:

You're welcome to check yourself with the Neuroplastic Pain Questionnaire from Lihi Lisser's (M.S.W) website. It's important to note that it isn't always possible to identify the source of the pain with 100% certainty. But combining ruling out a structural cause with identifying 'neuroplastic patterns' makes it possible to reach an accurate diagnosis, even if not a certain one.