When Rebecca came into my Ashland chiropractic office, her pain wasn’t the worst it had ever been—but it had been around the longest.

She’d injured her back seven years earlier, lifting her toddler from a car seat. Since then, she’d been through physical therapy, massage, two MRIs, a cortisone injection, and more ibuprofen than she cared to admit.

The odd part? Her most recent scan looked… normal.

No nerve compression. No severe disc herniation. Just “mild degeneration,” which her doctor said was normal for her age.

But her pain wasn’t normal. It flared when she sat too long. It shot down her leg after walking a few blocks. And it woke her up at night when she rolled over.

No one could explain why.

Until we talked about her brain.

Because here’s the truth:

Pain isn’t just in the back. It’s in the brain. And over time, it rewires how your entire nervous system works.

The Hidden Architecture of Chronic Pain

Your pain system is like a home security network: sensors (nociceptors), wiring (nerve pathways), a control panel (spinal cord), and a master switchboard (brain). It’s built to detect threats and activate protection.

When you experience an injury—like Rebecca’s back strain—the nociceptors in your tissues send electrical signals up the spinal cord to the brain. The brain interprets the threat and, if needed, generates pain to get you to stop, rest, or change behavior.

This is adaptive pain—and it’s brilliant.

But in chronic pain, the system malfunctions. What should have been a temporary alert becomes a full-on, long-term alarm. The sensors become too sensitive. The wiring thickens. The brain starts to perceive normal input as dangerous.

This is called neuroplasticity—and it’s the same mechanism that allows you to learn new skills or form habits. Unfortunately, chronic pain is a learned pattern, too.

What Happens in the Brain?

Research has shown that chronic back pain alters the structure and function of the brain. Specifically:

Gray matter density decreases in areas like the prefrontal cortex, which is involved in decision-making and emotional regulation¹
The somatosensory cortex, which maps body sensations, becomes distorted—meaning your brain literally forgets how to interpret movement accurately²
The limbic system (emotions) becomes more involved in pain perception, which explains why chronic pain and anxiety often go hand-in-hand³
The descending inhibitory system, which normally turns down pain, becomes less effective—so the brakes on pain are lifted⁴

This is not psychological. It’s physiological.

And the good news? Because the brain is plastic, these changes are reversible.

The Spinal Cord’s Role: The Pain Gateway

Before pain reaches the brain, it must pass through the spinal cord. Here, a dense network of neurons in the dorsal horn acts as a relay station. But over time, repeated pain input causes the spinal cord to change, too:

Second-order neurons become hyperexcitable
Glial cells (support cells in the CNS) release inflammatory chemicals like cytokines and glutamate
Even non-painful stimuli, like light touch or movement, begin to trigger pain (a phenomenon called allodynia)⁵

This is why pain can spread from the original site, why sitting can become unbearable even if the MRI looks stable, and why treatments that “should” work—like stretching or rest—can backfire.

The term for this amplification is central sensitization. And it’s one of the most common drivers of persistent low back pain.

How Movement, Mindset, and Manual Therapy Reverse the Cycle

So what can you do if your brain and spinal cord have been rewired by pain?

A lot, actually. But it takes a targeted, brain-aware approach—not just palliative care.

Here’s how we help patients in our Ashland clinic retrain their nervous systems:

1. Remap Your Brain With Movement

The brain thrives on accurate sensory input. When areas of the spine are stiff, guarded, or painful, the brain stops getting clear signals. This “sensory neglect” creates blurry maps in the brain’s motor and somatosensory cortices².

Through chiropractic adjustments, proprioceptive rehab, and movement exploration, we restore healthy input to these maps.

Mobilizing the spine wakes up dormant joint receptors
Guided movement retrains the brain to trust motion again
Balance, breathing, and light resistance work all help refine motor control

This isn’t about pushing through pain. It’s about finding safe, meaningful motion that the brain can re-integrate.

2. Use Neuroplasticity to Your Advantage

Because pain is learned, it can also be unlearned.

We help patients retrain their pain system through graded exposure, which means starting with small, successful movements and building up confidence and load gradually.

Each win tells the brain: this is safe.

With repetition, the pain system calms down. Glial activation decreases. The dorsal horn becomes less reactive. The prefrontal cortex starts to re-engage, taking back control from the overactive emotional centers.

This is not theory—it’s been observed on fMRI studies of chronic pain patients who recovered⁶.

3. Reframe the Meaning of Pain

Rebecca’s biggest shift didn’t happen on the table. It happened when she said, “I finally understand that pain doesn’t mean I’m broken.”

That reframe is everything.

Pain becomes less threatening when you understand it. And a less-threatening experience doesn’t trigger the same alarm system. That’s how education reduces pain—by reducing perceived danger.

We use analogies, imaging reviews, and simple neuroscience education to help patients shift their narrative from “damaged” to “adaptive.”

And once they believe it, the body follows.

Rebecca’s Brain Reset

Over 12 weeks, Rebecca’s pain faded—not because we “fixed” her spine, but because we changed how her system responded to it.

She learned to move without flinching. To walk without bracing. To interpret discomfort not as danger, but as a signal she could decode and work with.

Her prefrontal cortex reclaimed control. Her limbic system quieted. Her spine moved. Her life expanded.

And her pain? It stopped running the show.

You Can Rewire Your Pain System—Starting Now

If you’ve been living with back pain for months or years…
If you’ve been told “it’s all in your head” (it’s not)…
If your MRI doesn’t match your symptoms, or your treatments keep falling short…

There’s another way.

Your brain is not the problem.
It’s part of the solution.

And with the right strategy, you can teach it something new.

References

Apkarian AV, Sosa Y, et al. Chronic Back Pain Is Associated with Decreased Prefrontal and Thalamic Gray Matter Density. J Neurosci. 2004;24(46):10410-5.
Flor H, Braun C, et al. Extensive reorganization of primary somatosensory cortex in chronic back pain patients. Neurosci Lett. 1997;224(1):5–8.
Melzack R. Pain and the Neuromatrix in the Brain. J Dent Educ. 2001;65(12):1378–82.
Brumagne S, et al. Role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine. 2000;25(8):989–94.
Lotz JC, Ulrich JA. Innervation, inflammation, and hypermobility may characterize pathologic disc degeneration. J Bone Joint Surg Am. 2006;88 Suppl 2:76–82.
Luomajoki H, Moseley GL. Tactile acuity and lumbopelvic motor control in patients with back pain and healthy controls. Br J Sports Med. 2011;45(5):437–40.