Your Brain Might Be The Missing Link In Chronic Pain — Here’s Why
Most of us think of pain as something that happens in the body—a sore back, a tight shoulder, a lingering injury. And emotional pain? That feels like an entirely different category.
But emerging neuroscience suggests these two forms of suffering aren’t separate at all. In fact, they share overlapping circuits in the brain, which means your stress, anxiety, and past experiences may be shaping your physical symptoms far more than you realize.
On the mindbodygreen podcast, physician and double board-certified psychiatrist Daniel Amen, M.D., explains that chronic pain is best understood as a brain-based experience. Over the past three decades, his clinics have collected nearly 300,000 brain SPECT scans from people around the world, revealing a consistent truth: the brain determines how we feel pain, how intensely we feel it, and how quickly we recover.
When the brain’s pain-processing pathways are out of balance, small stressors can feel enormous, and physical discomfort can take on an emotional weight that’s disproportionate to the injury itself. This reframing doesn’t minimize pain. It gives us a roadmap for understanding (and healing) it more effectively.
Pain isn’t just physical; it's processed through three key brain pathways
Amen describes pain as a whole-brain event influenced by three major neural pathways. When these pathways are healthy, the brain can accurately assess threats, regulate responses, and calm the nervous system. When they’re disrupted, pain becomes louder, stickier, and more overwhelming.
The feeling pathway
This pathway starts in the thalamus, the brain’s central relay station, and sends signals to the parietal lobe to tell you where something hurts. Inflammation, chronic stress, or trauma can make this system hypersensitive, so even mild signals register as intense.
The suffering pathway
This pathway overlays pain with emotion. It’s the network that turns a simple ache into something distressing or fear-inducing. People with histories of anxiety, early adversity, or chronic stress often have an overactivated suffering pathway, making their physical pain feel heavier and more consuming.
The inhibitory, or calming, pathway
Centered in the prefrontal cortex, this pathway acts like the brain’s dimmer switch. When it’s functioning well, it regulates emotions, quiets catastrophizing, and helps the body return to baseline. But when it’s compromised, by lack of sleep, inflammation, substance use, trauma, or even chronic negativity, the brain loses its natural ability to turn down the intensity.
These pathways explain why two people with identical MRI findings can have radically different pain experiences. In fact, most older adults show abnormalities on spine imaging despite reporting little or no pain. The structure of the body tells only part of the story; the brain explains the rest.
Why emotional distress amplifies physical pain
Amen also explains the concept of the Doom Loop, a self-reinforcing cycle where emotional stress and physical pain feed each other until the entire system becomes overwhelmed.
The cycle often begins with pain for any reason: an injury, a difficult relationship, a stressful work period, or even unresolved grief. Once the suffering pathway is activated, the brain becomes more sensitive to discomfort. Worry increases muscle tension, poor sleep reduces recovery, and negative thoughts activate the same neural networks involved in physical pain.
Over time, the brain adapts to this heightened state, making pain feel more permanent, even if the original cause has healed.
People often respond with coping strategies that offer quick relief but worsen the loop: numbing with substances, avoiding movement, suppressing emotions, or mentally replaying fears about the future. These patterns weaken the prefrontal cortex, reduce emotional resilience, and keep the brain stuck in high alert.
How to strengthen the brain
The most empowering part of this brain-based model is that it’s not static. These pathways can be trained, nourished, and reshaped.
Support the prefrontal cortex
Activities that challenge coordination and focus, like table tennis, pickleball, dance, or learning a new skill, help strengthen the prefrontal cortex. This region plays a critical role in calming the nervous system and reducing pain amplification.
Avoid what disrupts pain-calming circuits
Alcohol, marijuana, nicotine, chronic sleep deprivation, and repeated head impacts all reduce frontal lobe activity. Even excess caffeine and visceral fat can impair blood flow to the areas responsible for emotional regulation, making pain feel more intense.
Address emotional patterns that precede physical symptoms
Many people notice resentment, sadness, anxiety, or persistent negative thoughts in the weeks or months before physical pain emerges. These are early signals that the suffering pathway is overloaded. Stress management, emotional processing, and cognitive reframing can keep those signals from becoming physical.
Support brain chemistry with targeted nutrition
Botanicals like saffron and curcumin, along with key nutrients such as zinc, may help support mood and inflammatory balance—both of which influence pain sensitivity.
Treat pain as a whole-system message
Instead of focusing on a single joint or muscle, ask broader questions:
- How was my sleep?
- What stress am I carrying?
- What am I suppressing emotionally?
- Which habit or relationship is draining me?
The body often expresses what the mind hasn’t had space to process.
The takeaway
Chronic pain isn’t just a structural or mechanical issue. It’s a dynamic brain process shaped by perception, emotion, memory, and resilience. When the brain’s pain pathways are supported, strengthened, and balanced, both emotional and physical pain become more manageable—and, in many cases, begin to fade.