Why Does Pain Keep Coming Back? Chronic Pain, The Nervous System & Healing Explained

1 out of 5 Australians is suffering from chronic pain. In my opinion, it’s probably more than that — but as a physiotherapist dealing with people in pain daily, I might be biased.

Chronic pain is defined as any pain that sticks around for more than 3 months — even if it comes and goes. That means if you have low back pain or neck pain that shows up 2–3 times a year, this is also considered chronic pain. It doesn’t have to be there every single day to count.

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I’ve witnessed incredible stories of healing unfold in my 23 years as a physiotherapist. Most structures heal within 3 months. But not everyone is pain-free by then.

We know people who share the exact same scan findings (disc bulges, degenerative changes) can be completely pain-free — or in agony. So what’s really going on?

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Pain is a message from your nervous system. It’s not just about tissue — it’s about perceived danger.

Step on something sharp and pain alerts you to check your foot. If there’s no real damage, pain usually settles down once the system is reassured. If there is a wound, pain calms as it heals. That’s acute pain: straightforward, protective, useful.

But why does your body still hurt, even though everything appears to be healed?

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Your nervous system assesses the whole situation when an injury occurs.

Have you noticed that stubbing your toe hurts way more when you’re already angry or stressed? That’s because stress lowers your system’s threshold — danger messages get sent earlier and louder.

This is what we call centralisation. It’s like an amplifier turned up too high — making sure nothing is missed.

And it’s not just the physical signal. The meaning of the situation matters. Imagine you can’t work because of knee pain. If your income depends on physical work, that pain becomes a bigger threat to your survival than if you had a desk job. Your nervous system knows that. No work could mean no income, which could mean not paying rent or your mortgage — a real existential threat. No wonder your body warns you more strongly.

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• Learn to move your body without compensation (Many people with low back pain avoid bending or twisting). Relax your muscles while you move. The Pocket Physio can help do that. Being careful means moving tensely, which increases the load on structures. If these structures are sensitive, movement might result in pain.

Over time, your tissues adapt, and your system calms down. It feels safe = less danger signals = less pain.

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I’ve been there too. During my neuro physio training in Germany, I once had to teach a 90+ kg man with hemiplegia (paralysis on one side) to walk down stairs before he could even stand or walk himself. I was the only one stabilising him — keeping him from falling down a full flight of stairs. I’m pretty bold, but that was stressful beyond belief.

I injured my neck during that 2-week training. The pain went away at first, but from then on it always came back. Sometimes with exercise, sometimes out of the blue. I saw physios, chiros, osteopaths, doctors — everyone had a different theory. I got stronger, more load-tolerant, but the random flare-ups never stopped.

It wasn’t until I moved to Australia to complete two Master’s degrees in physiotherapy that I finally learned the truth about chronic pain. Despite 12+ years of treating patients (from everyday people to elite athletes, including my 3 Swedish championship volleyball medals), no one had ever taught me the neurophysiology of pain.

When I learned how the nervous system processes pain, a whole new world opened up — for me and for my patients.

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One hidden driver of pain? Emotions.

During my Master’s, I practiced mindfulness to cope with stress. In one meditation, I was asked to recall a difficult memory. I was lying in bed, pain-free — until suddenly, in the memory, my neck cramped so badly I had to stop.

That was my lightbulb moment: one emotion can create physical pain.

Later, being diagnosed with ADHD at 43 gave me even more insight into why I often felt “not good enough.” My neck pain wasn’t random at all — it flared when that emotion was triggered.

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Since then, I’ve made it my mission to share this knowledge. Many practitioners still aren’t comfortable talking about the emotional and nervous system side of pain, because we aren’t trained psychologists. However, I’ve been fortunate to train with some of the world’s leading researchers in chronic pain, pain neurophysiology and cognitive functional therapy — an approach that combines psychology with physiotherapy.

Add in my empathy, intuition, a bit of humour, and yes — my ADHD superpower of talking a lot — and I’ve found ways to make this message land without being threatening.

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Your nervous system is always trying to protect you. The question is: where in your life do you not feel safe?

Because only when you feel safe — aligned with your values, your dreams, your environment — can your body relax enough to turn down the alarm.

Exercise, sleep, stress, diet, emotions, beliefs… they all feed into that sense of safety.

So instead of asking, “What’s wrong with my body?” try asking:

👉 “Why does my system keep warning me?”

That’s where real healing begins.