By Alex Klassen MSW, RSW

If you’ve felt confused by the different names used for mind-body pain/symptoms, you’re not alone! Between research, medicine, and counselling practices, there are several different terms being used to describe chronic pain and symptoms caused by the brain and nervous system.

This article will help you clarify the different terms you’ll commonly hear when learning about the science of pain and mind-body healing.

Term 1: Neuroplastic Pain/Symptoms

Neuroplastic pain/symptoms are generated by the brain in absence of structural damage, injury, or disease in the body¹. At MBody Community, and our counselling clinic Pain Psychotherapy Canada, we use this term when defining mind-body pain/symptoms. 

The reason we prefer this term is twofold. First, it helps our clients understand that brain pathways are plastic, meaning they can change and heal over time. The brain learns to amplify and generate unhelpful pain/symptoms, and it can also unlearn this! Second, neuroplastic pain is currently the leading term used in ongoing research and practice by fellow pain experts in our field.

Term 2: Nociceptive Pain/Symptoms

You can think of nociceptive pain/symptoms as helpful and accurate, as they occur when there is actual or threatened damage occurring to non-neural tissue². We need these pain/symptoms to keep our body safe from physical harm. Nociceptive pain/symptoms occur when the brain receives signals from the body accurately, generating helpful pain/symptoms to protect us from danger.

Term 3: Neuropathic Pain/Symptoms

Neuropathic pain/symptoms occur due to lesion or disease in the nerves, which send the wrong signals to the brain, resulting in pain and symptom generation². Neuropathic pain/symptoms can be physically assessed and are typically treated with medications, injections, and physical therapy³.

Terms 4 & 5: Chronic Primary Pain and Chronic Secondary Pain

Chronic pain is defined as pain that lasts or reoccurs for more than 3 months⁴. Chronic pain is classified as primary when there is no underlying physical condition that explains the pain, and secondary when there is an underlying condition that explains the pain.  These two types of pain can also coexist⁵. 

Much of the chronic primary pain experienced by our clients is neuroplastic, meaning is caused by a sense of danger and sensitization within the brain and nervous system. This means treatment can reduce symptoms by increasing a sense of safety in our thinking, nervous system, movement, and emotions¹. Furthermore, even when chronic pain is secondary (caused by a physical problem), many of the strategies designed to heal primary neuroplastic pain can still be helpful in turning down the volume knob in your pain system!

Term 6: TMS

TMS is an older term for neuroplastic pain/symptoms, which you’ll find within some online communities, readings, and education. The term has undergone evolution over the years, being called tension myositis syndrome, tension myoneural syndrome, and more commonly these days, mind-body syndrome.

TMS was first defined and diagnosed by Dr. John Sarno, a pioneering physician who treated and published books about chronic pain/symptoms. Sarno recognized that many of his patients were experiencing (primary) chronic pain without (secondary) physical problems, due to fearful beliefs about their body and unconscious emotional issues⁶. While Sarno made important contributions to the treatment and awareness and of mind-body pain, as we’ve learned more about the science of neuroplastic pain and symptoms, use of the term TMS has become less common.

To make it even more confusing, there are also a number of other terms for neuroplastic pain/symptoms that are used within different medical and research communities! These include:

• Neural Circuit Pain/Symptoms
• Nociplastic Pain
• Psychosomatic Illness/Pain
• Somatic Symptom Disorder or Somatoform Disorder
• Psychophysiologic Disorder
• Medically Unexplained Syndrome

Term 7: Central Sensitization

The term central sensitization is a term found in neuroscience and medicine, which helps explain why a person’s brain may be more sensitive when receiving the inputs of nerve signals, generating higher pain/symptoms than expected.

Scientists used to think the level of pain/symptoms experienced by an individual was directly controlled by the amount of peripheral stimuli occurring, meaning if there was high pain/symptoms, there must be something wrong in the body sending these signals to the brain⁷. We now know our pain system can sensitize due to changes in the properties of neurons in the central nervous system, resulting in the amplification of pain and symptoms⁷.

If you’re experiencing chronic neuroplastic pain/symptoms, you’re likely experiencing some degree of central sensitization in your nervous system. When there's ongoing stress, fear of movement, pain, and symptoms, the brain accidentally sensitizes and gets better at producing pain and symptoms⁸. This explains why we can develop multiple symptoms, spreading of pain, and/or increased intensity.  While central sensitization is frightening, remember the brain is plastic; neuroplastic symptoms can be reduced with the right tools and support!

If you’re experiencing chronic pain or symptoms like dizziness, fatigue or tinnitus, make sure to read our other blog posts to help gain a deeper understanding of the assessment and treatment available for neuroplastic pain and symptoms. Our course, The Somatic Safety Method, uses the latest evidence-based research and practices to help you heal the relationship between your brain, nervous system, and body!

References

1. Gordon, A., Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Sony/ATV Music Publishing LLC
2. International Association for the Study of Pain, 2024. Retrieved from https://www.iasp-pain.org/resources/terminology/
3. Cavalli E, Mammana S, Nicoletti F, Bramanti P, Mazzon E. (2019). The neuropathic pain: An overview of the current treatment and future therapeutic approaches. Int J Immunopathol Pharmacol. doi: 10.1177/2058738419838383. PMID: 30900486; PMCID: PMC6431761.
4. Treede, Rolf-Detlefa et al. (2019) Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). PAIN 160(1):p 19-27. | DOI: 10.1097/j.pain.0000000000001384
5. National Institute fo Health and Care Excellence. (2021). Chronic pain (primary and secondary overview).
6. Sarno, J. E. (1991). Healing back pain: the mind-body connection. Warner Books.
7. Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009 Sep;10(9):895-926. doi: 10.1016/j.jpain.2009.06.012. PMID: 19712899; PMCID: PMC2750819.
8. Moseley, L & Moen, D. (2024) Tame the beast: It’s time to rethink persistent pain. Retrieved from https://www.tamethebeast.org/#tame-the-beast