October 2026
Chronic pain can be complex, particularly when the level of pain doesn’t always seem to match what is happening in the body. In this blog, I explore what neuroscience can tell us about pain, why the brain plays such an important role and how Solution Focused Hypnotherapy may help you manage pain and its impact on everyday life…
If you live with chronic pain, you may have become very familiar with the question, “Where does it hurt?” It’s a reasonable question. If something hurts, surely there must be something physically wrong in that particular part of the body. Sometimes there is – arthritis, an old injury, inflammation, nerve damage or changes to the musculoskeletal system can all cause pain. But chronic pain is often much more complicated than simply identifying a damaged body part and assuming that the amount of damage will tell us how much pain someone should experience.
In fact, our understanding of pain has changed considerably over the years. I know this from both my professional interest in neuroscience and my own experience of living with chronic pain.
My own experience of chronic pain
I have lived with scoliosis since adolescence. Shortly after my initial diagnosis, I had surgery intended to correct the condition but, unfortunately, my spine and posture were not properly aligned following the operations. That has meant that my musculoskeletal system has spent many years compensating.
Some muscles work harder than they should. Other parts of my body have had to adapt to the way I stand and move. Over time, this has contributed to pain, stiffness and fatigue. As I’ve got older, the abnormal wear and tear has also led to arthritis in some of my joints. So, in my case, there are very real physical reasons for my pain. But what I’ve also learnt is that understanding pain involves understanding the brain. And this is where things get really interesting.
Pain isn’t simply a message from your body
When I was training, one of the things we learnt about was the Pain Gate Theory, developed by Ronald Melzack and Patrick Wall in the 1960s. The basic idea was that pain signals travelling towards the brain could be influenced by a kind of “gate” in the spinal cord. Depending on what was happening, the gate could allow more or less information through. For example, let’s say you bang your elbow on a door frame and an acute pain is immediately experienced. You furiously rub the injured area and somehow it doesn’t hurt as much. The mechanical signal of rubbing had the effect of preventing the pain signals from reaching the brain by closing this gateway.
The Pain Gate Theory was an important development in our understanding of pain, because it challenged the idea that pain was simply a straightforward message travelling from an injured body part to the brain. However, neuroscience has moved on considerably since the original theory was proposed and it is now understood to be incomplete and not entirely accurate, particularly when it comes to chronic pain. Research has shown that pain processing involves much more complex interactions throughout the nervous system, including processes in the brain itself.
There’s a distinction to be made here between “pain” and something called “nociception”. Pain is the experience that your brain produces in response to a combination of information, whereas nociception is the nervous system detecting potentially damaging or threatening stimuli. That combination of information may or may not include actual damage, but if you believe it does, your brain will signal pain and urge you to take action to protect yourself.
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”. It also specifically states that pain cannot be inferred solely from activity in sensory neurons. That distinction is hugely important.
Your brain is not just receiving information
We sometimes imagine the brain as rather like a computer receiving information from the body and displaying the result.
My knee is damaged > the nerves send a message > my brain receives the message > I experience pain.
But the brain doesn’t work quite like that. It is constantly processing information and trying to work out what is happening and what it needs to do to keep us safe. It considers information coming from the body alongside memories, emotions, expectations, attention and the environment.
This means that two people can experience very different levels of pain from apparently similar physical problems. It also means that the amount of tissue damage does not always correspond neatly to the amount of pain someone experiences. This doesn’t mean the pain isn’t real – quite the opposite, in fact. The pain is very real, because it’s the brain’s experience of pain that we’re talking about.
Monty Lyman explains this beautifully in “The Painful Truth”, as he explores how our understanding of pain has changed and why pain isn’t simply a direct measurement of damage in the body. He provides two excellent examples – one in which a serious injury occurred but no pain was actually felt until the injury was noticed, and one in which an apparent impalement caused intense pain but, upon investigation, it was found that the impalement had only pierced the person’s shoe and completely missed their foot. This latter example brilliantly illustrates how perception can play a large part in our experience of pain.
Why can chronic pain become so persistent?
Acute pain is usually helpful. If you touch something hot, your nervous system rapidly responds and you pull your hand away. If you’ve sprained your ankle, pain encourages you to protect it while it heals.
Chronic pain can be different. Pain that persists for months or years can continue even when the original injury has healed or when the relationship between the physical problem and the level of pain has become much less straightforward.
The IASP now recognises different mechanisms of chronic pain, including nociceptive pain, neuropathic pain and nociplastic pain. These are the three main mechanistic categories used by medical experts to classify how the body experiences and processes pain, and they can overlap. Nociceptive pain relates to damage in non-neural body tissue (think skin, muscles, joints, organs). Neuropathic pain is caused directly by a lesion, injury or disease affecting the somatosensory nervous system (the nerves that carry sensory information from your body to your brain). Nociplastic pain involves altered pain processing where the pain cannot be explained solely by ongoing tissue damage or a lesion of the somatosensory nervous system.
We can think of nociplastic pain as being a little like an alarm system. An alarm is incredibly useful when there is a genuine danger, but imagine an alarm system that has become increasingly sensitive. Eventually, relatively minor things might trigger a very loud response. This alarm isn’t “imaginary”. The system is genuinely producing the alarm. But the intensity of the alarm isn’t necessarily an accurate measurement of the danger. The nervous system has become over-sensitive.
The relationship between pain, stress and the nervous system
There is another important piece of the puzzle: stress. Whilst stress doesn’t necessarily cause chronic pain, chronic pain can certainly be stressful.
When we’re in pain, we may become more alert to physical sensations. We may worry about making things worse. We may avoid activities because we’re frightened of triggering more pain. We may become frustrated because things that used to be easy now take considerably more effort. And when pain, worry, poor sleep, fatigue and reduced activity start feeding into one another, life can gradually become smaller.
As a result, the brain’s threat system can become increasingly involved, leading to ongoing states of stress and anxiety. This doesn’t mean that someone is choosing to feel stressed or that their pain is caused by negative thinking. It means that the brain and nervous system are interconnected and that our emotional state can influence how we experience sensations.
This is one reason why learning to calm the nervous system and change our relationship with pain can be helpful.
So where does Solution Focused Hypnotherapy fit?
This is where I believe Solution Focused Hypnotherapy can have a useful role. It isn’t about telling someone that their pain isn’t real. It isn’t about persuading someone to ignore a physical condition. And it certainly isn’t about replacing appropriate medical care. Instead, the focus is on helping someone understand how their brain and nervous system respond to pain and then finding ways to improve their experience of living with it.
Solution Focused Hypnotherapy combines elements of Solution Focused Brief Therapy with hypnosis. Hypnosis involves a naturally occurring state of focused attention and can be used to help someone develop different responses to thoughts, sensations and experiences.
For someone living with chronic pain, this might involve exploring questions such as:
- What would you like to be able to do more comfortably?
- What would make a difficult day a little easier?
- When does the pain feel more manageable?
- What are you already doing that helps?
- If things improved by even 10%, what would you notice first?
These questions may sound simple, but they shift attention away from constantly monitoring what is wrong and towards identifying what is possible. That doesn’t mean pretending the pain isn’t there – it means making sure that pain isn’t the only thing your brain is paying attention to.
What does the research say about hypnosis and pain?
There is growing research into hypnosis and pain management, although it is important to be realistic about what the evidence tells us. A 2021 meta-analysis of 42 studies found that hypnosis was associated with reductions in clinical pain compared with control conditions. Research specifically looking at chronic musculoskeletal and neuropathic pain has also found potentially useful reductions in pain intensity and pain interference.
More recent research is helping to put those findings into perspective. A 2026 systematic review found that hypnosis produced modest reductions in clinical pain compared with inactive controls but did not clearly outperform other active approaches such as relaxation, pain education or CBT (Cognitive Behavioural Therapy).
That is actually useful information, as it suggests that hypnosis shouldn’t be presented as a magical cure for chronic pain. Instead, it can be considered as one potential tool within a broader approach to pain management.
NICE (National Institute for Health and Care Excellence – an independent UK public body) recommends approaches such as physical activity and psychological therapies including CBT and ACT (Acceptance and Commitment Therapy) for people with chronic primary pain, alongside appropriate assessment and management of the individual’s particular condition. For someone with a physical condition such as mine, that broader approach is particularly important.
Learning to live differently with pain
For me, managing chronic pain isn’t about finding a magic switch that makes everything disappear. There are days when my body reminds me very clearly that it has been compensating for many years. But understanding what is happening in the brain has changed the way I think about pain. Pain is information, but it isn’t necessarily a perfect measurement of damage.
The brain is involved in creating our experience of pain and the nervous system can become more or less sensitive. Our attention, expectations, emotions, memories and sense of safety can all interact with the experience. That gives us something important – it gives us possibilities.
We may not always be able to change the underlying physical condition. We may not be able to eliminate pain completely. But there may be things we can influence, including how we respond to pain, how much attention we give it, how we manage stress and how we continue to engage with the things that matter to us. And sometimes that can make a surprisingly meaningful difference.
If you’re living with chronic pain…
If you have persistent pain, it is important to seek appropriate medical advice so that underlying conditions can be assessed and managed. Solution Focused Hypnotherapy is not a replacement for medical treatment, physiotherapy or other appropriate pain management. But if pain has started to affect your confidence, sleep, mood, activities or quality of life, working with the brain’s response to pain may be another piece of the puzzle.
Sometimes the goal isn’t “How do I make the pain disappear?” A much more useful question could be “How can I live the life I want, even though pain is sometimes part of it?” That is a very different starting point.
If chronic pain is adversely impacting your life, why not book a free consultation with me and find out how Solution Focused Hypnotherapy could help.
Important note: this blog is for general information – any persistent or unexplained pain should always be assessed by an appropriate healthcare professional.