If you’ve ever learned to ride a bike, speak a new language, or recover after a stroke, you’ve experienced neuroplasticity—the brain and nervous system’s ability to change and adapt over time.

Neuroplasticity is the cornerstone of healing—but it can also be a double-edged sword. In chronic pain, this power can reinforce suffering. But the same mechanisms that entrench pain can also unwind it, if we guide them properly.

In this post, we explore what neuroplasticity is, how it contributes to both chronic pain and recovery, and why it’s a central pillar in treatments like Calmare/Scrambler Therapy.

WHAT IS NEUROPLASTICITY?

Neuroplasticity refers to the ability of the nervous system—brain, spinal cord, and peripheral nerves—to:

• Form new connections;

• Strengthen or weaken existing pathways;

• Reassign functions to different regions;

• Recover after injury or trauma;

It’s how we learn. How we form habits. How we adapt to new environments. And, importantly, it’s how the nervous system remembers pain.

HOW PAIN REWIRES THE NERVOUS SYSTEM

When pain becomes chronic, it’s no longer just a signal—it becomes a pattern. A loop. A reflex that gets reinforced over time. Here’s how neuroplasticity plays into it:

1. Synaptic Plasticity

Each time pain signals are sent through a neural circuit, the connections get stronger. This process, called long-term potentiation (LTP), is like practicing a piano scale—the more you repeat it, the more ingrained it becomes.

In chronic pain:

• Pain pathways are strengthened.

• “Non-pain” signals can start to trigger pain (sensory remapping).

• The brain becomes more efficient at producing the experience of pain.

2. Maladaptive Neuroplasticity

Neuroplasticity is neutral—it simply adapts to repeated input. But that adaptation can be helpful or harmful.

• In phantom limb pain, the brain remaps the missing limb’s area to nearby body parts, creating “ghost pain.”

• In fibromyalgia, regions of the brain associated with pain processing show increased activity and connectivity, even without injury.

The brain literally learns pain.

3. Central Sensitization Is Neuroplasticity Gone Wrong

As discussed in the last post, central sensitization is a plastic change where the CNS becomes hyper-responsive.

This involves:

• Upregulation of excitatory neurotransmitters

• Downregulation of inhibition

• Structural changes in the spinal cord and brain

The longer pain persists, the deeper these changes go. That’s why early intervention—and reversal—is key.

THE GOOD NEWS: NEUROPLASTICITY CAN WORK IN YOUR FAVOR

Just as the brain can learn pain, it can also unlearn it.

This involves:

• Strengthening non-pain pathways

• Reestablishing normal sensory input

• Dampening overactive pain circuits

• Building new sensory associations

Techniques that leverage positive neuroplasticity include:

• Graded motor imagery

• Mirror therapy

• Mindfulness and CBT

• Neuromodulation techniques like Scrambler Therapy

BRAIN AREAS INVOLVED IN PAIN PLASTICITY

Pain is not processed in one spot—it’s distributed across the pain matrix, including:

• Somatosensory cortex (location and quality)

• Anterior cingulate cortex (emotional response)

• Insula (internal body awareness)

• Prefrontal cortex (attention, meaning)

• Amygdala and hippocampus (memory and emotion)

These regions change structurally and functionally in people with chronic pain.

But they can also normalize when pain is successfully treated. This is the goal of any therapy that targets the neural roots of pain.