FAQs
Have questions about chronic pain, pain science, self-management, acceptance, central sensitization, or pain rehabilitation? Here are answers to some of the questions I hear most often.
What is chronic pain?
Chronic pain is pain that persists or recurs for more than three months. It can continue after an injury or illness has healed and can involve multiple contributing factors.
It's not imaginary or all in a person's head. It's a real, complex experience influenced by biological, psychological, and social factors.
Can chronic pain improve?
Yes. Chronic pain can improve and, in some cases, resolve. Recovery is possible.
Improvement doesn't look the same for everyone. It may mean less pain, better physical function, greater confidence, less fear or distress around pain, or simply being able to do more of the things that matter, even if some pain remains.
Understanding pain, reducing unhelpful struggle, developing self-management skills, and gradually returning to meaningful activities can help people change their experience of pain and build a fuller life.
Does pain always mean tissue damage?
No. Pain and tissue damage aren't always directly proportional. Pain can continue after tissues have healed, and people can experience significant pain without a clear structural explanation. Imaging findings also don't always explain how much pain someone experiences.
This is one reason pain is better understood as a protective experience produced by the nervous system rather than as a direct measurement of what's happening in the tissues.
Learn more about why you're not your X-ray →What is central sensitization?
Central sensitization happens when the nervous system becomes more sensitive and responds more strongly to signals.
This can contribute to increased pain sensitivity and may be one factor contributing to chronic pain. It doesn't explain every case of chronic pain.
Central sensitization and nociplastic pain are related, but they're not the same thing. Central sensitization describes increased sensitivity in the nervous system, while nociplastic pain describes a type of pain that isn't fully explained by tissue damage or nerve damage.
Central sensitization: what it is and how it relates to chronic pain →Watch the Mayo Clinic video →
Can stress physically turn up the pain volume?
Yes. When you feel nervous, stressed, or anxious, the brain and body respond with real physiological changes that can increase pain sensitivity and intensify the pain experience.
This can contribute to a cycle in which stress and pain reinforce each other, making chronic pain harder to manage.
The important point is that this doesn't mean the pain is imaginary or "just stress." Changes associated with stress are physical, and they can influence how the nervous system processes pain.
What is the biopsychosocial model?
The biopsychosocial model was introduced by George Engel in 1977. It goes beyond looking only at physical symptoms and tissues.
Instead, it considers biological, psychological, and social factors that can contribute to the overall pain experience.
Learn more about the biopsychosocial model →What is active self-management?
Active self-management means helping people develop the knowledge, skills, confidence, and support they need to participate actively in responding to chronic pain and managing daily life.
It can include pacing and activity modification, meaningful movement, relaxation, cognitive restructuring, sleep habits, goal setting, problem solving, and preparing for difficult days.
Active self-management doesn't mean managing chronic pain alone or giving up professional treatment. Healthcare professionals can provide treatment, education, guidance, encouragement, and ongoing support while helping people become more confident in managing day-to-day challenges.
Read more about active self-management →What does acceptance of pain involve?
Acceptance means recognizing chronic pain as part of the current reality rather than constantly fighting it or waiting for pain to disappear before life can move forward.
It doesn't mean giving up, stopping treatment, or believing that pain can't change. It means making room for the reality of pain while putting more energy into meaningful activities, connection, goals, and the parts of life that matter.
Watch "Pain and Me" with Tamar Pincus →Can chronic pain be managed without surgery or with reduced use of medications?
Sometimes. Treatment for chronic pain can include medications, procedures, physical or occupational therapy, psychological approaches, pain education, and active self-management. The appropriate combination depends on the person, the type of pain, and the circumstances.
For some people, rehabilitation and active self-management become a larger part of treatment over time. These approaches can help improve function, build confidence, and support participation in meaningful activities.
Medication changes, including tapering or reducing medications, should be individualized and discussed with an appropriate healthcare professional who understands the individual's circumstances.
Can exercise and activity make chronic pain worse?
Meaningful movement and gradually increasing activity can improve the pain experience for many people. Excessive rest and activity avoidance can contribute to deconditioning, reduced tolerance, isolation, and greater disability.
The goal isn't to push through everything. Finding an appropriate and sustainable level of activity is important. Pacing and gradual progression can help make activity more manageable.
What is pain rehabilitation?
Pain rehabilitation is a structured, interdisciplinary approach in which healthcare professionals work together to help people living with chronic pain improve function, develop active self-management skills, build confidence, and reconnect with meaningful activities.
The goal isn't simply to eliminate pain. It's to help people participate more fully in life, even when some pain remains.
Learn more about pain rehabilitation →Who is behind Chronic Pain Champions?
I'm Tom Bowen, the founder of Chronic Pain Champions. I've lived with chronic pain since 2009 and have experienced many of the challenges that can come with it, including years of searching for answers and treatments that would make the pain go away.
I've also attended formal interdisciplinary pain rehabilitation and spent years learning about pain science, self-management, and rehabilitation. Those experiences shaped the information and perspective I share through Chronic Pain Champions.
I'm not a healthcare professional, and Chronic Pain Champions isn't a medical practice. I share what I've learned from lived experience, pain rehabilitation, research, and conversations with healthcare professionals and people living with chronic pain. My goal is to provide useful information and perspectives that can help people have better conversations and make more informed decisions about pain care and help make life bigger than the pain.
Still have a question?
If you have a question about chronic pain, this website, or the resources available through Chronic Pain Champions, get in touch .
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