Chronic pain is not simply acute pain that has gone on for a long time. It is a different phenomenon, with different underlying mechanisms, a different relationship to the tissue from which it appears to originate, and a different response to treatment. Understanding this distinction is important for anyone who has been living with pain for months or years and has found that the treatments which seemed logical have not produced the results expected.
How Pain Becomes Chronic
Acute pain is a signal. It communicates that tissue has been damaged or is at risk of damage, and it motivates protective behaviour: resting the injured area, avoiding the movement that caused the injury, seeking treatment. This is adaptive. It serves the healing process.
In most cases, as the tissue heals, the pain diminishes and resolves. The signal is no longer needed and the nervous system withdraws it.
In some cases, this process does not complete as expected. The tissue heals but the pain persists. Or the pain becomes disproportionate to any identifiable structural cause. Or it spreads to areas beyond the original injury. Or it becomes responsive to stimuli that should not produce pain at all.
This is chronic pain, and its persistence is not, in most cases, a sign that the tissue is still damaged. It is a sign that the nervous system itself has changed.
Central Sensitisation
The nervous system has a remarkable capacity to adapt to its environment, which is generally a strength. In the context of chronic pain, this adaptability works against the person experiencing it. Sustained pain signals cause changes at multiple levels of the nervous system: in the peripheral nerves, in the spinal cord and in the brain. The threshold for pain signalling lowers. Neurones that previously required significant stimulation to fire begin firing more readily. Areas of the brain that process pain signals become more active and more sensitive.
The result is a nervous system that amplifies pain signals rather than accurately reporting tissue status. This is central sensitisation, and it explains why chronic pain often does not map neatly onto structural findings, why treatments directed at the structural level have limited effect, and why gentle approaches often succeed where more forceful ones do not.
Why Gentle Approaches Work Better in Chronic Pain
When the nervous system is sensitised, forceful treatment can exacerbate the problem. Adding strong mechanical stimulus to an already hypersensitive system may produce short-term benefit followed by flare and, over time, reinforcement of the sensitisation pattern.
Gentle approaches that work with the nervous system rather than attempting to override it are more consistent with the biology of central sensitisation. By providing input that the nervous system can integrate without triggering a threat response, they create the conditions for gradual recalibration rather than acute challenge.
Body stress release is designed around this principle. The minimal pressure used in BSR is deliberately non-threatening: it provides a precise neurological input without generating the defensive response that forceful pressure can provoke in a sensitised system. Over a course of sessions, the cumulative effect of this input supports the nervous system in releasing the holding patterns that are sustaining the pain.
For patients whose chronic pain also has a significant psychological component, as it often does when pain has been present for years and has shaped every aspect of daily life, counselling and therapeutic support addresses the cognitive and emotional dimensions that a purely physical approach cannot reach. The evidence for the effectiveness of psychological intervention in chronic pain is robust and well established.
If you are living with chronic pain that has not responded adequately to standard treatment, book a session with Peter van Minnen at Hever Health.