Learned pain as a leading cause of chronic pain

Thanks so much for writing this. I had basically an identical experience of developing chronic pain then spending two years ineffectively treating it with physical therapy before realizing it was psychosomatic and tied to my emotions. Once I read “the way out” I was halfway to being cured and today I feel 90-95% recovered. To anyone reading this in chronic pain there is hope. 

I wrote a blog post detailing my experience but yours is much more well researched and I’m glad you are spreading awareness of this. 

I think the EA community is probably much more prone to this issue for the following reason: personality traits that are a risk factor for chronic psychosomatic pain are pretty much identical with the stereotypical EA, namely;

• “High in any of these personality traits: self-criticism, pressure, worrying and anxiety, perfectionism, conscientiousness, people pleasing - these correlate with neuroplastic pain”
   

Good writeup!
Pathways is another online treatment program. There are also workbooks like The Pain Management Workbook.

I haven't looked into this literature, but it sounds remarkably similar to the literature of cognitive behavioral therapy and graded exercise therapy for ME/CFS (also sometimes referred to as 'chronic fatigue syndrome'). I can imagine this being different for pain which could be under more direct neurological control.

Pretty much universally, this research was of low to very low quality. For example, using overly broad inclusion criteria such that many patients did not have the core symptom of ME/CFS, and only reporting subjective scores (which tend to improve) while not reporting objective scores. These treatments are also pretty much impossible to blind. Non-blinding + subjective self-report is a pretty bad combination. This, plus the general amount of bad research practices in science, gives me a skeptical prior.

Regarding the value of anecdotes - over the past couple of years as ME/CFS patient (presumably from covid) I've seen remission anecdotes for everything under the sun. They're generally met with enthusiasm and a wave of people trying it, with ~no one being able te replicate it. I suspect that "I cured my condition X psychologically" is often a more prevalent story because 1) it's tried so often, and 2) it's an especially viral meme. Not because it has a higher succes rate than a random supplement. The reality is that spontaneous remission for any condition seems not extremely unlikely, and it's actually very hard to trace effects to causes (which is why even for effective drugs, we need large-scale highly rigorous trials).

Lastly, ignoring symptoms can be pretty dangerous so I recommend caution with the approach and approach it like you would any other experimental treatment.

Executive summary: This exploratory post argues that "neuroplastic pain"—pain generated by learned neural patterns rather than tissue damage—is a widely accepted explanation for many chronic pain conditions, yet remains underrecognized in mainstream medicine; the author shares personal experiences of dramatic improvement through psychological treatments, suggesting these may offer substantial relief for a broad range of patients.

Key points:

1. Neuroplastic pain is well-supported by recent research and recognized by major medical authorities (e.g., WHO), yet many doctors remain unaware due to its recent emergence in medical literature.
2. Many chronic pain conditions previously linked to structural causes—including back pain, joint pain, and even headaches—are now understood to often stem from neuroplastic mechanisms, and this could represent the most common cause of chronic pain.
3. Fear and threat perception can reinforce and amplify pain through a self-perpetuating “fear-pain” cycle; learning that pain is not harmful can be critical to recovery.
4. Psychological treatments like Pain Reprocessing Therapy (PRT) and somatic tracking show large effect sizes in clinical trials and have proven highly effective for the author, who experienced dramatic symptom relief after years of suffering.
5. Accurate diagnosis of neuroplastic pain relies on patterns such as symptom inconsistency, emotional triggers, and lack of physical injury, but belief in the diagnosis is often hindered by evolved instincts and misleading medical imaging results.
6. Effective treatments include pain neuroscience education, emotional regulation, and certain medications, with recommended resources like The Way Out and the Curable app offering structured guidance for patients.

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