Redefining Chronic Pain (The 3-month rule)
Chronic pain is very much a medical term that can be sometimes misunderstood by the general public who assume this indicates severe or unrelenting pain. Whereas it means only that your pain has lasted for longer than three months and says nothing about its intensity or severity.
The reason for three months is because tissue will mostly be healed after three months has passed. That means the pain you continue to experience is not from any tissue damage, because tissue does heal, it is no longer physical pain.
Because of this, medications may be ineffective, and you move into treatment that only manages your pain.
What makes chronic pain complex is the different responses that people experience:
- Constant pain that is always there regardless of its location.
- Pain of various levels of intensity that comes and goes.
- Pain that is made worse by stress or brought on by stress.
- Pain that continues following an injury or surgery (after tissue has healed).
- Pain that can come on months after injury or surgery for no acceptable reason.
One of the worst aspects of living with pain is the effect it can have on your work and lifestyle.
- Can cause problems with relationships, family, and friends.
- Can dash career hopes and aspirations.
- Cause you to become depressed or develop anxiety.
- Can lead to long term disability.
- Pain can rob you of your enjoyment of hobbies and activities.
- All of these above can lead to loneliness and further illness.
MRIs may not provide the answer to your chronic pain.
It is now accepted that there are positives and negatives about searching for the cause of your pain. Although an MRI may be necessary to rule out conditions such as fractures or tumours they can give us a negative perception on our pain. Unfortunately, as we age so does our body, so degeneration, bulging discs etc. are a normal part of aging and also vary with time as the body continually changes.
Research in areas such as back pain or rotator cuff pain, is continually educating us on how these changes in our structure cannot provide the reason for our pain. Though being told you have degeneration is still a scary message and hard to ignore. However, clinicians are now interpreting MRIs with the understanding of normal aging.
Neuroplasticity: The brain as the solution
New neuroplastic ideas are changing the way that chronic pain and other chronic conditions are treated for those: -
- Unable to get a diagnosis.
- Told there's nothing wrong.
- There is no cure for their ongoing symptoms.
- Have conditions that no longer respond to treatment.
- They have been told that they have to live with their chronic pain.
- No medical treatment has made any difference to their symptoms.
Neuroplasticity that is changing the neural networks in the brain can impact pain and recovery from chronic pain, of many different diagnoses. Sometimes a client will enter my room looking for hope – yes hope is positive and a good starting point.
Nociplastic pain is a term that means the pain is still 100% real and "physical" in the sense that nerves are firing and the brain is processing signals, but the source has shifted from a "wound in the body" to a "sensitised nervous system.
However it’s important to bear in mind that changing your mindset can be difficult and take time. To change pain messages with regular use of self-help techniques is not as simple as taking a pill or having an injection.
To learn more about the support for those looking to start a journey to recovery visit Jean Jordan's chronic pain program:
https://www.naturalpainsolutions.nz/chronic-pain-coach-jean-jordan
About the Author:
Jean Jordan
Jean has been a practising naturopath for over 20 years. During her naturopathic training in Perth, she developed a strong interest in chronic pain, which led her to undertake a clinical research project focused on persistent musculoskeletal pain. Her research highlighted how past life experiences and unresolved stress can contribute to ongoing pain, and demonstrated that acknowledging these factors and using targeted self-help techniques can support meaningful pain relief.
References
Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(1):13–23.
Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816.
Ibounig T, Järvinen TLN, Raatikainen S, et al. Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging. JAMA Intern Med. Published online February 16, 2026.
Dr. Howard Schubiner Mind Body Medcine
Freedom from Chronic Pain – information and training
https://www.freedomfromchronicpain.com
Treede RD et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain, 2019. https://pubmed.ncbi.nlm.nih.gov/30586067/
Kosek E et al. The concept of nociplastic pain - where to from here? Pain, 2024. https://pubmed.ncbi.nlm.nih.gov/39560415/
