For many clients, symptoms appear or worsen around the time of a particularly stressful or emotional event. Examples could include a wedding, divorce, new baby, family illness or death, beginning university, financial difficulties, career stressors, etc. It’s not about the event itself, but the level of nervous system dysregulation experienced; even events that seem small can trigger neuroplastic pain2,11.

Pain/symptoms often occur without a clear injury2,11.

“I woke up with the pain/symptoms” or “It just got worse over time”

If you are injured, pain/symptoms are appropriate at first. However, most injuries heal within a few weeks to a few months. Your body evolved to heal! If the symptoms emerge without injury, or persist long past the typical time of healing, it could be a sign it’s neuroplastic.

Problems in relationships, difficulties at work, and systemic stressors like loneliness, poverty, racism, gendered oppression, or sexuality-based oppression can cause increases in pain/symptoms. If your pain/symptoms worsen when stress and emotional difficulty are high, and reduce when you feel safe and calm, it’s a sign they are neuroplastic2,11.

Stimuli and activities like weather, smells, foods, workplaces, noises, or lighting can become unexpected triggers for pain/symptoms. If your brain has associated certain stimuli with danger, then to protect you from the danger, it will generate neuroplastic pain/symptoms - and this reinforces the sense that the stimuli is indeed dangerous. If you are noticing triggers you wouldn’t expect to cause physical pain/symptoms, it could mean your symptoms are neuroplastic2.

Structural injuries, damage, and diseases in the body typically behave quite consistently. In contrast, with neuroplastic pain/symptoms, your symptoms may change day-to-day. Sometimes it’s quite confusing, as there’s no clear sense of why it feels better or worse. Quicker, confusing, or more spontaneous shifts in symptom location and intensity suggest they are neuroplastic2,11.

The spread of symptoms often causes fear, confusion, and frustration, but on the bright side, it can suggest your pain/symptom is neuroplastic and treatable with a mind-body approach. Structural pain/symptoms are typically localized to injury sites or structural problems in the body. If your symptoms have migrated around the body over time, or become symmetrical, this suggests they may be neuroplastic rather than structural2,11.

If there are multiple symptoms occurring in your body that are difficult to explain, sensitization in the brain and nervous system may be the common explanation. While multiple chronic pain/symptoms could be coming from injuries or systemic disorders, when medical assessment finds no structural cause or cure, it suggests a sensitized brain is the central cause2. This can look like:

• Having 3 or more chronic pains/symptoms

• A history of serial symptoms (one after another)

Sometimes we engage in a physical activity or tasks, and it feels okay in the moment, only for pain/symptoms to flare up later. Structural pain/symptoms don’t typically behave this way. Injurious movements/stimuli should cause symptoms while they are happening. Pain/symptoms emerging after exposure to a movement, activity, or stimuli are often neuroplastic, not structural2.

• Example: I go for a bike ride and experience higher pain the next day

• Example: I feel dizzy after a busy day

If you’ve had various scans, tests and assessments, and physicians/specialists are unable to find a structural problem to accurately explain your symptoms, it can suggest they are neuroplastic. Furthermore, many of our clients have been given a structural diagnosis, yet their symptoms are neuroplastic.

If the diagnosis just isn’t making sense, or you’ve tried many different physical treatments and medications with little success, it can suggest that you are trying to heal problems in the wrong place.

We always recommend an extensive physical assessment from a skilled medical provider. However, if structural problems can’t be accurately diagnosed and treated, it may be time to shift your treatment focus from the body to the brain and nervous system2,11.

Pain and symptoms are designed to protect us. So is entering a nervous system state of fight, flight, fawn, or freeze/shutdown. Bodies are designed to move in and out of danger, but becoming stuck in states of dysregulation can sensitize and trigger neuroplastic pain.

Experiences of neglect, trauma, bullying, and accidents in childhood can lead to feeling unsafe in your body and relationships. Research shows strong connections between childhood adversity and developing chronic pain/symptoms. A brain that feels chronically unsafe is more at risk of developing neuroplastic pain and symptoms2,12,13,14,15.

Survivors of physical, sexual, and psychological trauma are much more likely to develop chronic pain/symptoms. Adults are 2.7 times more likely to have chronic widespread pain, fibromyalgia, chronic fatigue, or IBS, following trauma in childhood or adulthood4. Furthermore, higher rates of dizziness/vestibular concerns were found with veterans who have PTSD compared to veterans who didn’t have PTSD12.

While not always considered, the experiences and life impacts of chronic pain/symptoms can also cause trauma. Sensitization trauma is prolonged dysregulation caused by the onset and progression of chronic pain/symptoms. Medical trauma is prolonged dysregulation caused by medical procedures, experiences, or treatments16,17. Trauma that is not processed and healed can lead to the development and amplification of neuroplastic pain/symptoms. 

Chronically dangerous or oppressive social factors that cause individuals to feel unsafe in their world and relationships can cause pain/symptoms. Studies show social factors such as poverty, abusive relationships, racism, bullying, and being part of the LGBTQ+ community can significantly increase the likelihood of experiencing chronic pain and symptoms7,9,13,18. Pain/symptoms can be viewed as meaningful messages; the brain is signalling danger in an attempt to protect.

Through attempts to understand and fix the problem, individuals with chronic pain/symptoms often develop pathological beliefs about their bodies. Through interactions with various health professionals, forums, and online research, many concerning physical conditions may be learned. While structural diagnosis is meant to help, when the symptom is actually neuroplastic, pathological labels can create increased fear, confusion, frustration, and despair. Viewing the body as broken, abnormal, or unable to heal increases fear, changes behaviour, and amplifies neuroplastic pain/symptoms.

*Please note it is important to meet with a medical professional to ensure neuroplastic symptoms are assessed properly. Please do not use these criteria to diagnose yourself. We request all of our clients first see a physician to ensure medical conditions with a clear physical cause have been ruled out. For a formal diagnosis of neuroplastic symptoms, we refer our clients to physicians specialized in it.