Neurological Signs of Chronic Pain: Insights from Research

Key Points

• Chronic pain alters the nervous system, reshaping both brain and spinal cord activity.
• Neurological signs can include sensory changes, cognitive fog, and mood disturbances.
• Advances in imaging reveal structural and chemical shifts in pain-processing regions.
• Recognising these signs improves diagnosis and helps guide more targeted therapies.

When Pain Rewrites the Nervous System

What if chronic pain wasn’t just about aching joints or a sore back—but about your brain rewiring itself? Recent scientific findings show that long-lasting pain can trigger lasting changes in the nervous system, affecting cognition, emotions, and behaviour. For millions of people worldwide, this means chronic pain is not only a lingering sensation but also a neurological event—changing how the brain and body communicate long-term.

This realisation reframes the conversation about pain. It is no longer enough to manage discomfort at its source; understanding chronic pain requires us to look deeper into the nervous system, where subtle neurological signs often hold the key to long-term outcomes.

Why Neurological Signs Matter in Chronic Pain

Understanding these brain-level changes helps explain why chronic pain behaves differently from short-term pain.

Chronic pain is a growing public health challenge, affecting more than 20% of adults in the United States. Unlike temporary pain, which alerts us to injury and typically subsides, persistent pain lingers for months or years and reshapes how the brain and spinal cord process signals. These changes don’t just influence pain itself—they affect memory, mood, and everyday functioning.

If left unrecognised, the neurological dimension of chronic pain can lead to misdiagnosis, inadequate therapies, and reduced quality of life. By shining a light on the neurological signs, researchers and health professionals hope to improve early detection, tailor therapies more effectively, and help users regain a sense of control over their daily lives.

Recognising the Neurological Footprint of Chronic Pain

Neurological signs of chronic pain often remain overlooked because they don’t always fit the stereotypical image of pain. These neurological signs vary widely, but research repeatedly highlights four key categories.

• Sensory changes – numbness, tingling, or unusual sensitivity to touch.
• Cognitive difficulties – problems with focus, memory, and decision-making.
• Motor coordination issues – slower reflexes or changes in movement patterns.
• Emotional shifts – increased irritability, anxious thoughts, or depressive states.

These signs not only complicate diagnosis but also compound the burden of pain in everyday life. People often describe frustration at feeling “foggy,” struggling to keep up at work, or withdrawing from social interactions.

However, severe or sudden changes—such as muscle weakness, loss of sensation, or bladder/bowel changes—should prompt urgent medical evaluation, as they may indicate problems beyond chronic pain.

The Brain and Nerves on Alert

Scientists now know that chronic pain is tied to central sensitization—a process where the nervous system becomes hyper-responsive. Brain imaging studies show reduced grey matter in areas such as the prefrontal cortex and thalamus, which are critical for regulating pain and emotions.

• Neuroplasticity: Repeated pain signals can rewire brain circuits, strengthening pathways that amplify pain. However, neuroplasticity also allows the brain to rewire in beneficial ways, which is why targeted therapies can gradually reverse some of these changes.
• Spinal cord alterations: Changes in spinal signalling can lower the threshold for pain, making mild touch, pressure, or temperature changes feel disproportionately painful—a hallmark of central sensitisation.
• Neurochemical imbalances: Shifts in neurotransmitters like serotonin and dopamine can impact mood and motivation, further linking chronic pain to depressive states.

These findings help explain why chronic pain often persists even after the initial injury has healed.

Approaches That Target Both Body and Brain

While there’s no single solution, research points to approaches that target both the body and brain:

• Mind-body therapies – mindfulness, yoga, and meditation show evidence of reducing central sensitisation and improving user outcomes.
• Neuromodulation therapies – wearable devices that stimulate nerves, such as non-invasive vagal neuromodulation, are being studied for their ability to regulate nervous system activity.
• Cognitive and behavioural approaches – strategies like cognitive-behavioural therapy (CBT) help users manage the emotional and cognitive effects of chronic pain.
• Pharmacological support – medications can reduce nerve sensitivity, though they work best when combined with non-drug solutions.

Together, these strategies highlight the importance of interdisciplinary care that addresses both neurological and physical aspects of pain.

Taking Action for Better Care and Diagnosis

If you or someone you know is experiencing persistent pain alongside symptoms like numbness, memory difficulties, or mood shifts, it may be time to seek professional advice. These signs are not just minor side effects; they can be indicators of bigger neurological changes that deserve attention.

Keeping a simple 1-week symptom journal—tracking pain intensity, emotional shifts, numbness, sleep changes—can help health professionals identify neurological patterns more quickly.

A health professional can also help identify these patterns, recommend advanced imaging when appropriate, and design a care plan that addresses both nervous system regulation and pain relief. Taking action early doesn’t just reduce suffering in the present—it may prevent further neurological complications in the future.

Conclusion

Chronic pain is not only a physical sensation—it’s a neurological experience that reshapes the brain in measurable ways. By understanding these signs and addressing both body and brain, individuals and health professionals can pursue more precise, effective care. The path to relief lies in recognising pain as a whole-system experience and managing it with the same depth and complexity that science demands.

This blog post aims to be informational and should not replace professional health advice. Always consult with a health professional for personalised advice.

Subscribe for Free for more insightful health articles tailored to your needs.

Sources

1. Rikard M. Chronic Pain Among Adults — United States, 2019–2021. MMWR Morbidity and Mortality Weekly Report [Internet]. 2023 Apr 14;72(15). Available from: https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm
2. De Ridder D, Adhia D, Vanneste S. The Anatomy of Pain and Suffering in the Brain and Its Clinical Implications. Neuroscience & Biobehavioral Reviews [Internet]. 2021 Nov;130(130):125–46. Available from: https://www.sciencedirect.com/science/article/pii/S0149763421003560
3. Jaffal SM. Neuroplasticity in chronic pain: insights into diagnosis and treatment. The Korean journal of pain [Internet]. 2025 Jan;38(2):89–102. Available from: https://pubmed.ncbi.nlm.nih.gov/40159936/
4. Haslam BS, Butler DS, Kim AS, Carey LM. Neuropathic Symptoms and Frequency of Chronic Pain in an International Online Sample of Individuals with Sub-Acute and Chronic Stroke. Healthcare. 2025 Feb 20;13(5):455.
5. Dydyk A, Conermann T. Chronic pain [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553030/
6. Cui C, Liu H, Yue N, Du Y, Che L, Yu J. Research progress on the mechanism of chronic neuropathic pain. IBRO Neuroscience Reports [Internet]. 2022 Dec;14. Available from: https://www.sciencedirect.com/science/article/pii/S2667242122001038