A Better Approach to Treating Chronic Pain

To reduce pain we need to reduce the credible evidence of danger and increase credible evidence of safety.
— Lorimer Moseley

Pain science is always changing. And the more we understand about how our brain creates and interprets pain, the better we can treat and manage acute and chronic pain.

The Old Approach - A Bottom-Up Model

Traditional pain science has suggested that pain comes from the bottom up. Meaning that we injure a certain area of our body, and that area of the body tells the brain that we're in pain. Makes sense for a traumatic, acute injury. A fall stimulates nociceptors (pain receptors) which relay pain up to the brain. 

But what about pain that has stayed for months/years without a significant injury? The tissue (joints/muscles/tendons/ligaments etc.) in your body have healed, but you're still experiencing pain. What gives?

The New Approach - A Top-Down Model

New Pain Science is showing that pain (especially chronic pain) comes from the top down (from our brain to our body). The idea is that pain is a sensation that the brain creates to inform us of a perceived threat to our body so that we avoid further aggravation/injury. Good for an acute injury but becomes a problem if that messaging continues to be sent even after the injury as healed.

What This Means for Care

If chronic pain really is the result of mismanaged brain signaling, it won't matter how many adjustments, massages, or other passive therapies we perform. Why? Because the tissues have already healed. The real goal should be to convince the brain that there is no longer a threat. And that is can be (at least somewhat) accomplished through a structured, progressively challenging exercise plan.

Also keep in mind, that a lot factors influence pain. Many (most) times it isn't just a physical phenomenon but can be influenced by what you eat, how you feel, how well you sleep, and other lifestyle factors. With this knowledge we can better treat chronic pain that plagues so many people in our community.


Evolve Performance Healthcare specializes in creating sustainable pain relief by combining full body chiropractic care with therapeutic fitness programs to improve movement patterns and create functional strength. We're here to help so feel free to contact us with any questions.

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