Mind Your Body Podcast
Inspiration: Episode 15: How to Recover from Pain of the Mind Your Body podcast with Dr. Nevo.
I’ve spent years watching people fight their own bodies.
They push through pain. They rest when told. They try every treatment. And still, the pain persists.
The problem isn’t that healing failed. The problem is that your body learned to protect you so well that it forgot how to stop.
The Protective Habit Trap
When you first got injured, your body made brilliant decisions. It tightened muscles around the damaged area. It shifted your posture to avoid stress. It created compensatory movement patterns to keep you functional.
These weren’t mistakes. They were survival mechanisms.
But here’s what most people miss: those protective habits don’t automatically turn off when the tissue heals.
Your shoulder injury healed months ago, but you still hike that shoulder up when you reach. Your back pain resolved, but you still brace your core before bending. The original threat is gone, but your nervous system is still running the same protective program.
And that program is exhausting.
The Energy Cost of Protection
Protective habits demand constant energy. Muscle guarding requires ongoing tension. Altered posture creates strain in new areas. Compensatory movements recruit muscles that weren’t designed for those jobs. [1]
You’re not just dealing with the original injury anymore. You’re dealing with the accumulated cost of months or years of protection.
This is where secondary pain syndromes emerge. Your knee started hurting because you’ve been favoring your ankle for six months. Your neck is tight because you’ve been holding your shoulders differently since that car accident. The original problem created a cascade of adaptations, and now you’re managing multiple issues instead of one.
The brain doesn’t differentiate between imagined threat and real threat. If it thinks you need protection, it will keep those habits running. [2]
Why Pain Becomes Emotional
Here’s what the research shows: in chronic pain, the brain areas processing pain increase from roughly 5% of nerve cells to 15-25%. Pain literally spreads across your brain, becoming more significant over time. [3]
But there’s more. Learning mechanisms within the limbic circuitry transform acute pain into chronic pain and render it more emotional. [4] What started as a physical sensation becomes intertwined with fear, frustration, and anticipation.
You’re not imagining this. Chronic pain fundamentally changes how your brain processes pain, shifting it from a sensory experience to an emotional one.
Fear-avoidance beliefs create a vicious cycle. The anticipated threat of intense pain causes constant vigilance and monitoring of pain sensations. This vigilance can make even low-intensity sensations unbearable. You avoid activities, which leads to inactivity, which ultimately leads to greater disability. [5]
Your brain is trying to protect you. But the protection itself has become the problem.
The Neuroplasticity Paradox
Here’s the insight that changes everything: the same neuroplasticity that created your pain patterns can undo them.
Pain is often the result of learned neural pathways in the brain. Just as pain can be learned, it can be unlearned. The alterations in your brain associated with chronic pain are modifiable and reversible with effective interventions. [6]
This isn’t wishful thinking. This is measurable neuroscience.
Your brain physically changes structure in response to experience. It prunes unused neural pathways for efficiency. It automates responses through repetition. It makes decisions to conserve energy. [7]
The brain that learned to produce pain can learn to stop producing it. But you have to give it new information.
The Seven-Phase Recovery Framework
Recovery from chronic pain isn’t about eliminating symptoms. It’s about reprogramming the protective habits your body developed.
This requires a structured approach that addresses both physical and emotional aspects:
Phase 1: Acknowledge the pain without letting it consume your identity. The pain is real. The threat may not be.
Phase 2: Rest strategically, not indefinitely. Your body needs recovery, but prolonged inactivity reinforces the fear-avoidance cycle.
Phase 3: Understand why the habits formed. What was your body protecting? What threat was it responding to? This understanding creates the foundation for change.
Phase 4: Address the emotional component. Fear, frustration, and negative expectations significantly impede healing. You can’t separate physical recovery from emotional regulation.
Phase 5: Retrain movement patterns. Start with gentle movement and mindfulness. Build tolerance gradually. Your brain needs evidence that movement is safe.
Phase 6: Create new neural pathways through consistent practice. Neuroplasticity requires repetition. One good day doesn’t reprogram years of protective habits.
Phase 7: Maintain the new patterns. Recovery isn’t a destination. It’s an ongoing practice of choosing healthier responses.
This isn’t a linear path. It’s a spiral. You’ll revisit phases. You’ll have setbacks. That’s not failure. That’s how nervous system retraining works.
The Biopsychosocial Reality
There’s strong evidence that intensive multidisciplinary biopsychosocial rehabilitation with functional restoration improves function compared to non-multidisciplinary treatment. Comprehensive pain treatment that addresses the biopsychosocial aspects of the pain experience is not only more clinically effective than conventional medical treatment by itself—it’s also more cost-efficient. [8]
You can’t treat chronic pain by addressing only the body. You can’t treat it by addressing only the mind. You have to address the complex interplay between physical healing, nervous system regulation, emotional processing, and social support.
This is why traditional approaches often fail. They’re treating the wrong problem. They’re trying to fix tissue that already healed instead of reprogramming the protective response that outlived its usefulness.
What Recovery Actually Requires
Recovery demands that you become an agent of change in your own healing.
You need to identify your protective habits. Notice when you brace. Observe when you avoid. Recognize when you’re guarding against a threat that no longer exists.
You need to capture moments when pain is less. Your brain needs evidence that safety is possible. Those moments of reduced pain aren’t accidents—they’re data points showing you what works.
You need to visualize a pain-free future. Not as fantasy, but as possibility. Your brain’s predictive capacity influences your pain experience. If you can’t imagine being pain-free, your nervous system has no reason to change its protective programming.
And you need patience with the process. Healing requires patience with the healing process itself. New behaviors require more initial effort than automated habits. Your brain will resist change because change is metabolically expensive.
But the brain can change. The brain will learn. You just have to give it consistent, repeated evidence that the old protective habits are no longer necessary.
The Path Forward
Pain is information. It’s your nervous system’s best attempt to protect you based on the information it has.
But information can be updated. Neural pathways can be rewired. Protective habits can be released.
The question isn’t whether your body can heal. The question is whether you’re willing to do the work of teaching your nervous system that it’s safe to let go of the protection.
That work is both physical and emotional. It’s both scientific and personal. It’s both structured and intuitive.
And it starts with understanding that the habits keeping you in pain were once the habits keeping you safe. They served you well. Now it’s time to thank them for their service and teach your body a new way forward.
Recovery is possible. Neuroplasticity is real. Your brain can unlearn pain.
You just have to show it how.
Your Next Step
This week, notice one protective habit. Just observe it.
Pay attention to when you brace before bending. Notice when you tense your shoulders while reaching. Catch yourself avoiding a movement you once did easily.
You don’t need to change anything yet. Awareness is the first step. Your nervous system can’t release what it doesn’t recognize.
Three questions to ask yourself:
1. What movement or position am I avoiding, and what am I afraid will happen if I try it?
2. When does my pain feel less intense, even slightly—and what’s different in those moments?
3. What would I do differently tomorrow if I trusted my body was safe?
Write down what you notice. These observations become the map for your recovery.
About the Author
Dr. Zev Nevo is a double board-certified physiatrist, chronic pain survivor, and founder of the Body & Mind Pain Center. He helps people with persistent pain rebuild capacity and confidence using an evidence-based, trauma-informed mind-body rehabilitation approach.
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Medical Disclaimer
The information in this article is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article. New or changing pain symptoms should always be properly evaluated by a medical professional.
References
[1] Dalton, E. (2018). Protective muscle spasm. Erik Dalton Blog. Available at: https://blog.erikdalton.com/protective-muscle-spasm/
[2] Schmaltz, M. (2019). Muscle guarding: The pain cycle. Dr. Martin Schmaltz. Available at: https://drmartinschmaltz.com/muscle-guarding-the-pain-cycle
[3] Northern Pain Centre. (2021). Understanding chronic pain: Neuroplasticity – what, why and how. Available at: https://www.northernpaincentre.com.au/wellness/understanding-chronic-pain-2/neuroplasticity-what-why-and-how/
[4] Hashmi, J. A., Baliki, M. N., Huang, L., Baria, A. T., Torbey, S., Hermann, K. M., Schnitzer, T. J., & Apkarian, A. V. (2013). Shape shifting pain: Chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 136(9), 2751-2768. https://doi.org/10.1093/brain/awt211
[5] Leeuw, M., Goossens, M. E., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. (2007). The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. Journal of Behavioral Medicine, 30(1), 77-94. https://doi.org/10.1007/s10865-006-9085-0
[6] Moseley, G. L., & Flor, H. (2012). Targeting cortical representations in the treatment of chronic pain: A review. Neurorehabilitation and Neural Repair, 26(6), 646-652. https://doi.org/10.1177/1545968311433209
[7] May, A. (2011). Experience-dependent structural plasticity in the adult human brain. Trends in Cognitive Sciences, 15(10), 475-482. https://doi.org/10.1016/j.tics.2011.08.002
[8] Gatchel, R. J., McGeary, D. D., McGeary, C. A., & Lippe, B. (2014). Interdisciplinary chronic pain management: Past, present, and future. American Psychologist, 69(2), 119-130. https://doi.org/10.1037/a0035514