Can Neurofeedback Help with Chronic Pain?
Written by Colleen Longua BCN-T, QEEG-T, ISF
Understanding Chronic Pain
Chronic pain is a catch-all term for many different conditions ranging from migraines, to lower back pain, to fibromyalgia, and many other types of pain. At its most basic, chronic pain is defined as pain that lasts for more than 3 months. An estimated 20% of people worldwide suffer from some kind of chronic pain. Needless to say, it is a major concern in the world of healthcare. The need to better understand and treat chronic pain has caused a surge in better research and cutting edge interventions. As we learn more about the link between pain and the brain, neurofeedback has emerged as a potential option for managing chronic pain conditions and providing much-needed relief.
There are three primary types of pain: nociceptive, inflammatory, and neuropathic pain. Nociceptive pain is a sensory response to real or potential stimuli that can hurt us. If you have ever stubbed your toe, sprained an ankle, or skinned your knee, you have experienced nociceptive pain. Nociceptive pain acts as the body's alarm system, signaling when there has been potential tissue damage. Inflammatory pain is the body’s response to damage that often comes immediately after an injury. This is due to a flow of immune cells into the damaged area as the body works to repair itself. Neuropathic pain is a localized pain that often persists well after an injury. Neuropathic pain is a kind of misfiring of the nervous system, causing it to send pain signals even if there is no damage present.
All three kinds of pain can turn into chronic pain. Our nervous system is constantly sending signals to our brain and vice versa. Pain is a way that our bodies communicate to tell us something has gone wrong. If the underlying cause of the pain is not resolved, or if these pain signals become dysregulated or stuck, it can result in chronic pain. It’s important to note that this is a very simplified version of pain and the underlying causes of chronic pain can be very complex.
The Intersection of Chronic Pain and Mental Health
Pain is a whole-brain experience. Many different areas of the cortex, as well as deeper brain structures are involved in how we process and perceive pain. As we learn more about the brain, we have been able to better understand the underlying mechanisms causing our brains to end up in pain loops. A major factor for many chronic pain conditions is neuroinflammation. This occurs when brain cells called glial cells become activated and stay activated for long periods of time. Glial cells are a key part of the brain’s immune system and are activated by injury, stress, or infection. However, when glial cells are overactive, this creates prolonged inflammation in the brain, leading to increased sensitivity to pain signals. This neuroinflammatory response essentially can turn the volume up on pain and is an underlying cause of many chronic pain conditions such as fibromyalgia, migraines, and neuropathic pain.
Our brains are made up of many different overlapping networks. These networks work together to shape how we experience pain. In turn, pain can rewire these networks, changing how our brains operate over time. One of the areas that is most significantly impacted by chronic pain is the amygdala. The amygdala is a small structure, deep in the brain that is heavily involved in threat detection, emotion, and, you guessed it, pain. When the amygdala turns on, it can often get “stuck”, leading to heightened anxiety, agitation, and poor sleep. This in turn, can negatively affect your mental health, creating a negative feedback loop that can make managing chronic pain more difficult.
By understanding how these networks are involved in chronic pain, we can begin to retrain the brain’s circuitry. This not only can reduce pain perception but it can also improve mental health outcomes, helping you to feel like yourself again.
What the Research Tells Us
There is a strong body of research supporting neurofeedback as a safe and effective intervention for many chronic pain conditions. A 2020 systematic review looked at over 6,000 studies on neurofeedback for chronic pain and found that neurofeedback more broadly could improve chronic pain as well as mental health symptoms associated with chronic pain conditions. Further studies have found that infraslow neurofeedback specifically is particularly beneficial when helping reduce chronic pain symptoms. As of today, more research is still needed to fully understand the underlying mechanisms in the brain that cause chronic pain. However, what we do know is that neurofeedback is a low-risk, science-based intervention that can significantly improve quality of life for chronic pain sufferers.
In my own experience as a clinician, I have seen clients experience much needed relief from a variety of chronic pain conditions, including migraines, tendinosis, long-COVID, Chron’s, and neuropathic pain. Clients often report other improvements including an improvement in sleep and a reduction in anxiety and brain fog. These changes, in turn, help improve mental well-being, making pain conditions easier to manage and heal from. Here at Mind Body Neuro, we offer a variety of neurofeedback options to help reduce chronic pain and help you get your life back. We are committed to getting to know your brain and your specific needs and developing individualized care to help you find relief from pain. If you or someone you know is dealing with a chronic pain condition, if you feel like you have tried everything else, or if traditional therapies and treatments aren’t doing enough, reach out to our team today. Let us help you take control of your pain and start feeling like yourself again.
Resources:
Adhia, D. B., Mani, R., Mathew, J., O’Leary, F., Smith, M., Vanneste, S., & De Ridder, D. (2023). Exploring electroencephalographic infraslow neurofeedback treatment for chronic low back pain: A double-blinded safety and feasibility randomized placebo-controlled trial. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-28344-2
Adhia, D. B., Mani, R., Turner, P. R., Vanneste, S., & De Ridder, D. (2022). Infraslow neurofeedback training alters effective connectivity in individuals with chronic low back pain: A secondary analysis of a pilot randomized placebo-controlled study. Brain Sciences, 12(11), 1514. https://doi.org/10.3390/brainsci12111514
Ho, T., & Ryan, M. (2026). Chronic pain as a state-constrained brain network disorder: A dynamical systems model integrating physiological regulation and self-organisation. Frontiers in Pain Research, 7. https://doi.org/10.3389/fpain.2026.1825571
Is inflammation in your brain causing chronic pain? (n.d.-a). https://www.michiganneurologyassociates.com/blog/is-inflammation-in-your-brain-causing-chronic-pain
Mathew, J., Adhia, D. B., Smith, M. L., De Ridder, D., & Mani, R. (2022). Source localized infraslow neurofeedback training in people with chronic painful knee osteoarthritis: A randomized, double-blind, Sham-controlled feasibility clinical trial. Frontiers in Neuroscience, 16. https://doi.org/10.3389/fnins.2022.899772
The research on neurofeedback for chronic pain | infraslow associates. (n.d.-b). https://isfassociates.com/neurofeedback-for-chronic-pain/
Roy, R., de la Vega, R., Jensen, M. P., & Miró, J. (2020). Neurofeedback for pain management: A systematic review. Frontiers in Neuroscience, 14. https://doi.org/10.3389/fnins.2020.00671
Yang, S., & Chang, M. C. (2019). Chronic pain: Structural and functional changes in brain structures and associated negative affective states. International Journal of Molecular Sciences, 20(13), 3130. https://doi.org/10.3390/ijms20133130
