If Your Chronic Pain Does This… It's NOT Coming From Your Body (How To Heal It) | Howard Schubiner

June 3, 2026 1h 27m

Feel Better, Live More

Key Takeaway

Pain isn't always caused by structural damage—your brain creates pain as a protective signal, and it can do this in response to stress, fear, or emotions just as powerfully as physical injury. This revolutionary understanding means chronic pain can often be 'unlearned' by addressing the brain's danger signals through awareness, emotional processing, and reframing your relationship with symptoms. Start today by noticing when your pain changes with stress or context—that awareness is the first step toward recovery.

Episode Overview

Dr. Howard Schubiner explains how most chronic pain is neuroplastic—generated by the brain in response to stress and emotions rather than structural damage. He debunks common myths about pain, discusses why MRI findings often don't correlate with symptoms, and presents a five-part treatment model emphasizing assessment, education, symptom reappraisal, emotional processing, and lifestyle changes to help people unlearn chronic pain.

Key Insights

Pain Is Created by the Brain, Not Just the Body

The brain determines whether pain occurs, not just tissue damage. You can have injury without pain (like Howard's friend who shot a nail in his hand), and pain without injury (like stress-induced headaches). This revolutionary understanding shifts how we approach chronic pain treatment—focusing on the brain's interpretation of danger signals rather than assuming structural damage.

MRI Findings Often Don't Explain Chronic Pain

Disc degeneration, bulging discs, and spinal abnormalities increase with age in people WITHOUT pain. By age 50, 60% of pain-free people have disc degeneration; by 60, it's 80%. Studies show that reading MRI reports with scary terminology (like 'degeneration') can actually worsen pain and lead to more unnecessary procedures.

Chronic Pain Can Be Unlearned Through Neuroplasticity

If pain can be learned as a conditioned response to certain triggers (standing, stress, activities), it can be unlearned. Gary's story exemplifies this—after 25 years of severe pain, he recovered in 6 weeks once he understood his pain was neuroplastic and started sending his brain messages of safety while gradually returning to normal activities.

Self-Awareness Is the Gateway to Healing

Recognizing the connection between your emotions, stress, and symptoms is transformative. When Gary saw his pain jump from 5 to 9 just by seeing a long pharmacy line, he realized 'that was my brain.' This awareness opens the door to addressing root causes rather than endlessly chasing structural explanations.

Fear and Danger Signals Amplify Pain

The brain evolved to create pain as a protective alarm when it perceives danger—physical OR emotional. Stress and emotions activate the same brain regions as physical injury. Understanding this removes shame and blame while empowering people to address the emotional and psychological factors maintaining their pain.

Notable Quotes

"You can't understand pain unless you understand the brain. Everyone understands pain. Everyone knows that your body's damaged when you have pain. So the first myth is that pain always is caused by some structural damage or injury to the body."

— Dr. Howard Schubiner

"The brain determines whether there's pain or not. That is revolutionary and remarkable just that. And you can have pain in the absence of injury. So when you put those two facts together, they're facts. You can have an injury and have no pain. You can have pain without an injury. Now you have to ask yourself the question, when you have pain, what is it? What's going on? And that opens the door to a whole new understanding of what pain is."

— Dr. Howard Schubiner

"It's a question of what's most important. If you're running across the field and you break an ankle, you want pain. You need pain. Your brain is turning on pain. But if you're running and someone's chasing you, maybe you wouldn't get pain because the fear, the danger of being chased is greater than the danger of the injury."

— Dr. Howard Schubiner

"If pain and we'll talk about anxiety, depression, fatigue. If those sensations can be learned, they can be unlearned. And that hope and that agency that you talk about where people feel like they can do something makes all the difference in the world."

— Dr. Howard Schubiner

"Normal healthy people starting in their 20s and 30s start to have disc degeneration as seen on an MRI. But people without pain have very high levels of disc degeneration. So if you're in your 50s you have a 60% chance of having disc degeneration. If you're in 60s you have an 80% chance of having disc degeneration with no pain."

— Dr. Howard Schubiner

Action Items

1
Cultivate Self-Awareness of Pain Triggers
Start noticing when your pain changes—does it vary with stress, certain people, locations, or thoughts? Track these patterns in a journal. Awareness of these connections is the first step toward understanding neuroplastic pain and beginning to address it.
2
Send Your Brain Messages of Safety
When pain flares, pause and consciously reassure yourself that you're safe and not damaged. Practice this regularly, especially when engaging in activities you've been avoiding due to pain. This helps retrain your brain's danger detection system.
3
Gradually Resume Avoided Activities
Like Gary who couldn't walk but started walking anyway, gently return to activities you've been avoiding. Start small, remind yourself you're not causing damage, and progressively increase. Movement with the right mindset can help unlearn conditioned pain responses.
4
Reframe MRI Results with Context
If you have an MRI showing 'abnormalities,' remember that these same findings exist in 60-80% of pain-free people your age. Don't let scary medical terminology increase your fear—ask your doctor to explain findings in the context of normal aging rather than as definitive causes of pain.