Neuroplastic Pain: Why Your Thoughts Matter More Than You Think

If you’ve had tennis elbow—or any pain—for a long time, you’ve probably heard some version of this sentence:

“I’ve tried everything. Nothing works for me. This is just my life now.”

I hear it all the time.

It’s understandable. When you’ve bounced from provider to provider, done months of treatment with little progress, maybe even tried injections or surgery, it’s natural to feel defeated.

But here’s what the science is telling us: your pain is not just about your elbow. Your brain is involved too—and that’s actually good news.

Acute Pain vs Chronic Pain

Let’s start with something simple.

• Acute pain is new. You roll your ankle, cut your finger, or touch a hot pan and immediately drop it. Pain in those moments is your body’s warning signal: “Hey, pay attention—don’t damage this further.”

• Chronic pain is different. Once pain has been going on for longer than about three months, those pain signals can get “stuck.” The volume gets turned up, and the alarm keeps ringing long after the tissue damage has settled.

This is where neuroplastic pain comes in.

What Is Neuroplastic Pain?

Neuroplastic pain is pain that comes from changes in the nervous system itself—rather than ongoing damage in the tissue.

Over time, with ongoing pain, your brain and spinal cord get better and better at producing pain. The system becomes more sensitive. You might notice that even light touch, a small movement, or a familiar activity can trigger a big pain response.

Here’s the part I love telling people:

Those changes are reversible.

We see this on functional MRI scans—special brain imaging that lets us watch how the brain behaves under different conditions. We used to say “these things make you feel better.” Now we can literally see that certain practices change the chronic pain brain.

How Your Thoughts Change Your Pain

Twenty years ago, if you’d told me that thoughts could meaningfully change pain, I probably would have brushed it off.

Now, we can’t ignore it.

Positive and negative thoughts have different signatures in the brain. They change the chemistry and connectivity of the areas involved in pain processing. That means your inner dialogue can influence:

• How intense your pain feels

• How quickly you recover

• How well your strategies and treatments work

Common thoughts I hear from long-term pain clients:

• “This is never going to get better.”

• “Nothing has worked; nothing will.”

• “I’ll be like this forever.”

These are completely understandable—but they keep your nervous system in a heightened, threatened state.

The Power of Reframing

I’m not talking about denial or pretending everything is fine.

I’m talking about gently catching a thought and choosing a more helpful one. For example:

• From: “This is going to be my life forever.”To: “I’m doing the right strategies to heal. This flare is uncomfortable, but I know I can get through it.”

• From: “Nothing works for me.”To: “I’m still in the process of finding what works for my body. I’ve already made progress, even if it’s slower than I’d like.”

My clients often describe this as a “switch flipping” moment. One member told me that shifting her daily mantra from “this is so painful” to “yes, it’s painful—but I know it’s getting better” was life-changing.

Gap vs Gain: A Helpful Mental Framework

There’s a concept in self-development called the Gap and the Gain. (The Gap and The Gain is a book by Dan Sullivan and Dr Benjamin Hardy.)

• The Gap is when you only look at how far you still have to go. “I’m still not pain-free. I should be further along. This is taking too long.”

• The Gain is when you look back at how far you’ve already come. “A year ago, I couldn’t lift groceries. Now I can. I still have pain, but I’m in a very different place.”

Both are true. But living in the Gap keeps your nervous system on high alert. Living in the Gain helps your system feel safer—and a safer system heals better.

When my clients pause and reflect—“Two or three years ago I couldn’t do X; now I can”—you can almost feel the energy shift on the call.

Your Brain Is Not the Enemy

None of this means “it’s all in your head” in the dismissive way people sometimes use that phrase.

It means your brain is part of your body and part of your pain. And that gives us extra doors we can walk through to help you heal.

Practices like meditation, time in nature, breathing, yoga, and relaxation aren’t “soft add-ons.” They are brain-training tools that help reverse neuroplastic pain changes.

So the next time your mind says, “This is hopeless,” see if you can take one step back and ask:

“Is there a more helpful version of this thought that’s still true?”

Your elbow will thank you for it.

How Empowered Relief Accelerates These Mindset & Pain Improvements

One of the most powerful tools for shifting neuroplastic pain is the Empowered Relief® class I teach each month. This 2-hour, research-backed program—developed by pain psychology experts at Stanford—gives you practical strategies to calm your nervous system, reduce pain intensity, interrupt negative thought loops, and build confidence in your ability to heal. If the ideas in this blog resonate with you, Empowered Relief will help you put them into action in a structured, science-based way. You can learn more and sign up for the next class directly on my website, HERE.