Persistent Pain After Injury Recovery
Image by Nattanan Kanchanaprat from Pixabay
Have you “recovered” from injury, but still feeling pain? I often work with athletes and post injury/surgery clients who are perplexed because their doctor, physiotherapist, and scans say that they have recovered from their injury, but they are still having persistent pain—especially when they are transitioning back to their training routines. They want to know why and wonder whether it is all in their head.
There are a number of reasons pain can continue long after the tissues seemed to have healed. Understanding why and selecting an effective treatment starts with understanding how our bodies perceive pain. All types of pain are interpreted as pain by a complex process involving several areas of our brain—so technically all pain happens in our head.
With an injury, signals are sent from the point of injury up to our thalamus (our brain’s relay station) which forwards the information to other parts of the brain for interpretation (Complete Neurological Care, 2024). Areas of our cerebral cortex interpret the location and intensity of the pain and compare it to previous experiences. Areas of our limbic system are responsible for interpreting the emotional aspects of pain.
When we experience chronic pain (lasting more than 3-6 months), changes can occur in the structure and function of parts of the brain. Changes in neuroplasticity can affect the electrical activity in areas of our brain that can even change the size of the areas of our brain that process pain signals and how the pain is perceived (Complete Neurological Care, 2024). Past injury experiences, traumas, stress levels, and our support system can all impact the pain cycle.
The interaction of our nervous system with our immune system and endocrine (hormone) system contribute to the complexity of the healing process and our pain experience (Azevedo & Medina-Ramírez, 2025). Areas of our brainstem are involved in the flow of messages within our bodies and can play a role in pain relief (Complete Neurological Care, 2024).
Learning to speak the language of your nervous system with tools that help you cope when you are experiencing pain and also using proactive prevention can have a dramatic impact on your pain experience and get you back to performing at pre-injury levels and beyond. Treatments such as Eye Movement Desensitization and Reprocessing (EMDR) can help disrupt the pain cycle and reestablish healthy, adaptive functioning (Brothers, 2024).
Tonia Anderson is a Registered Psychologist (RPsych) specializing in health and performance psychology. She has taken speciality training in the use of EMDR therapy for pain management and medical conditions and regularly works with athletes at the junior, amateur, and professional levels with injury and surgery recovery, chronic pain, concussions, and other medical conditions that impact performance and wellbeing. Tonia has a track record of clients recovering to pre-injury levels, peak performances, personal bests, and National team selections.
Book a free consultation or first session with Tonia at https://toniaandersonpsychology.janeapp.com or email tonia@toniaandersonpsycholocolgy.ca to get started.
References:
Azevedo N,& Medina-Ramírez R. (2025). Pain and the autonomic nervous system. The role of non-invasive neuromodulation with NESA microcurrents. Front Pain Res (Lausanne). doi: 10.3389/fpain.2025.1410808.
Brothers, G. (2024). EMDR Therapy and Chronic Pain, EMDRIA. https://www.emdria.org/blog/emdr-therapy-and-chronic-pain/
Complete Neurological Care (Sep 9, 2024); The Neurology of Pain: How Our Brains Interpret Pain; https://www.completeneurologicalcare.com/post/the-neurology-of-pain-how-our-brains-interpret-pain