Chronic Pain and the Nervous System: What You Need to Know

Why does pain sometimes continue long after an injury heals? Why can stress make symptoms worse? And what does the nervous system actually have to do with chronic pain?

In this episode, Deb Timmerman and Lindsay Vertalka take a practical look at the connection between chronic pain and the nervous system and why understanding that connection can change the way people approach healing and recovery.

Together, they explore how the body’s stress response, pain pathways, emotions, movement, sleep, and daily stressors can all influence the pain experience. They also discuss why chronic pain is often far more complex than simply “something being wrong” structurally in the body.

In this episode, you’ll learn:

•  How the nervous system influences chronic pain 
•  Why pain can persist even after tissues heal 
•  The role stress and overload can play in pain cycles 
•  How the brain and body work together in the pain experience 
•  Why calming the nervous system matters 
•  Practical ways to begin supporting recovery and resilience 

Whether you’re living with chronic pain yourself or supporting someone who is, this episode offers a grounded, hopeful look at how the body responds to stress, pain, and healing.

Video version of this podcast: https://youtu.be/UjQrhR0Ocdc

Heart Focused Breathing Tool

Lindsay's Pain Diagram

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Website: LessStressinLife.com/podcast/

Stay tuned for more conversations to empower you to live well, manage stress, and build a thriving, healthy life!

Transcript

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Deb Timmerman 0:05

Welcome to the Less Stress in Life podcast. I'm Deb Timmerman, founder of Less Stress in Life, registered nurse, and board certified reflexologist. I help people navigate the stressors of chronic illness and understand how stress can feed ongoing pain cycles and impact overall health.

Lindsay Vertalka 0:24

And I'm Lindsay Vertalka, a master's level licensed physical therapist. I help people move through injuries, disabilities, and chronic conditions using a holistic approach that blends movement with the mental and emotional side of living with pain. Between the two of us, we've worked with and experienced chronic illness, both professionally and personally.

Deb Timmerman 0:44

This season, we're focusing on what it really looks like to live well with chronic illness. We're here to bring you practical tools, research-backed insights, guests who are walking this path, and fresh approaches you may not have tried so you can feel more hopeful, more informed, and more supported along the way. Welcome back to the Less Stress in Life Podcast. Today, we are talking about Chronic pain, it is your jam.

Lindsay Vertalka 1:35

Yeah, it is. And we're gonna nerd out a little bit today.

Deb Timmerman 1:37

Okay. So why don't we start with defining what chronic pain is?

Lindsay Vertalka 1:44

So, chronic pain is generally pain that lasts more than six months. And I mean, it can be episodic, it can flare, it can get worse and get better, but it's there as kind of a long term.

Deb Timmerman 1:58

Chronic pain has an opposite, and that is acute. So acute pain is the stuff that's short duration. Can you give us an example of the difference between chronic pain and acute pain?

Lindsay Vertalka 2:11

For sure. As an example, if you are stepping down a curb and sprain your ankle, you might have sudden sharp pain in that ankle, have swelling, bruising, use crutches for a short period and have pain. And then eventually, with time, maybe within a month or two, it starts to feel better. Sometimes it's sooner. If you have pain and symptoms, difficulty walking that lasts for a lot longer than that, well, we start to think about what's going on? Why is there still pain? Because tissues are healed by about six months. So sometimes it can be what I say is more of a nervous system issue than a tissue issue.

Deb Timmerman 2:55

Okay, let's talk about that a little bit. What do you mean by a nervous system issue?

Lindsay Vertalka 3:01

Yeah, so the nervous system is very complex. Your nervous system composes three parts. And the first one is your brain. If you think of your brain as a control center, the brain's constantly getting information, you're making decisions using your brain, and the brain sends messages back to the body. The second part of your nervous system is your spinal cord, and that is like a highway. Think of it as a highway, and it carries messages back and forth between your brain and the rest of your body. And the third part of the nervous system is basically the nerves. And we have, I think it's over 45 miles of nerves in our body, and think of it as multiple roads and highways. And nerves give your brain information about pain, about temperature when something is cold or hot. Nerves activate muscles so that you can use your muscles to move things or to even walk. So the nerve sends messages to the brain, and the brain kind of is again the control center that interprets the message.

Deb Timmerman 4:14

Okay, so like if I touch a hot stove, my nerve in my finger sends a message to my brain that says, hot - danger, take your finger off. And so, then my brain sends another message to move the finger. So, it's a two-way highway.

Lindsay Vertalka 4:30

Exactly.

Deb Timmerman 4:30

Okay. Love it. I can relate to that. So, the nervous system's main job then is really to protect us.

Lindsay Vertalka 4:41

Yeah, it is. And it decides what's dangerous. The nerves don't decide, but your brain's very complex and pretty amazing. But yeah, it decides how to interpret that, the message it's getting, and whether I need to protect you.

Deb Timmerman 4:59

Okay, so let's talk about that ankle injury. You talked about the sprained ankle being acute. So, if that sprained ankle as you were falling off a curb was something traumatic to your body, and your brain forms a snapshot of that as, ooh, this was a horrible experience. How is that going to affect how long pain stays around? Will that hinder or help your healing process?

Lindsay Vertalka 5:29

Well, it can go either way sometimes.

Deb Timmerman 5:32

Okay. So let's talk about. I think we all know what the good way is. The good way is your body goes, okay, this is temporary. Yeah, I'm done with this, I'm healed, I can move on, and I'm using my ankle to walk again. No residual effects. But what about the pain that stays around long after we think it should be healed?

Lindsay Vertalka 5:54

Yeah. So even our pain experience, or when we have injuries, our nervous system that I'm talking about is affected by our brain has memory and can remember previous experiences. So previous experiences and the stress or trauma we've had in our life affects our nervous system. And for some people, obviously, people have different experiences, or you know, I have worked with patients that have repeatedly sprained their ankle. And so each of those instances might come with its own memory. And say you're walking down the street and you roll your ankle on the curb and a bus is coming. Your brain decides, do I need to get up and run? Or am I goin lay here while the bus is coming? Well, the brain usually decides that the bigger threat is the bus. And so you're able to get up and move and then kind of calm down, and and then your body draws attention to it. Oh, now my ankle hurts, you know.

Deb Timmerman 6:56

So if I'm hearing you correctly, anytime there's anything associated with a threat, the brain records that as such. And if you've had multiple injuries to an ankle, it might remember all those injuries and then start to set up a feedback loop where you're healed, but your nerves are still irritated, and the stress of that is making that loop be unbreakable.

Lindsay Vertalka 7:32

Yeah. And like I said, our brain remembers, and so maybe a previous instant of an ankle sprain was very traumatic. Maybe it caused you to not be able to work and led down a path of financial stress. That you know, then there's that loop of I've got financial stress, and now I've got anxiety, and that anxiety and even sometimes depression affects your nervous system.

Deb Timmerman 7:59

abAbolAbSo the body sends a false alarm to protect us rather than fail to protect us when something really dangerous is happening. Right. Yeah, yeah. Interesting. Yeah. So if we have a surgery, say, maybe we have a foot surgery and it doesn't go quite right, maybe you had more done than expected, or you had problems with the tissue healing after, and you think about it as being a horrible negative experience, does that sometimes affect the amount of pain or continued pain that you could have?

Lindsay Vertalka 8:43

Absolutely. So, part of what I do in physical therapy is how can we reframe that experience and recognize, like if I'm in this loop of being negative and very focused on you know what's wrong with my foot and being angry about it, that doesn't help the process of healing, improving the symptoms.

Deb Timmerman 9:10

Oh, I just heard you say that our emotions affect how we feel and interpret pain.

Lindsay Vertalka 9:16

For sure. You want to talk about that, Deb?

Deb Timmerman 9:20 Deb Timmerman 9:21

Uh, sure. Gosh, where to start on that? I think for many years we looked at the body as one thing and our mind as something else, yeah, another thing, and we treated physical symptoms as physical symptoms and emotional symptoms as psychiatric symptoms. And the new research says it's all intertwined. The body and the emotions are all they're like a big jumble of yarn or a big ball of rubber bands that you stick together. They are not separate from each other, and when we feel an emotion, it changes the way information gets to our brain, and it also affects the nervous system in terms of our sensory perception, how we feel pain, how we experience pain, all of it. So we're no longer looking at things like that as separate entities, but as a mind-body connection.

Lindsay Vertalka 10:28

Absolutely. We can't separate the two. They go hand in hand, exactly like you said. The good news that I kind of want to talk about is what's encouraging is we can change our nervous system. And that's part of the purpose of, I think, our podcast is to provide you with tools and ideas or resources to find to help and change that nervous system. It's called neuroplasticity, is the big fancy nerd term. Do you want to explain what that is, Deb?

Deb Timmerman 11:00

Yeah, it means that our nervous system can be retrained to use different pathways. So, if there's an accident at one of the neuropathways that are running to the brain and back down, say that accident happened on the route with the ankle injury that we talked about, we can teach the brain to perceive differently and make a new neuropathway or a new communication pathway to bypass what we already have. So that sounds crazy, but one of the easiest ways to do that is with the tool of reframing that Lindsay talked about and our breath. So, it turns out that our nervous system is influenced by our emotions, and our emotions are first felt by our heart, not our brain, and that the heart sends more information to the brain than the brain sends to the heart. So, if we are feeling really anxious about that pain, and we choose a breath tool and a reframing tool, and we can get that signal to our brain, it will help us calm down. So it also helps other things in the body. Think about when you're tense, your heart rate increases, and all of your blood vessels constrict. And so when that happens, it makes pain feel more intense because there's this whole chemical cascade that goes on in your body because your body thinks it's under threat. So it's sending all these things, these hormones, to moderate that experience, and it can be influenced by breath and how you think about it.

Lindsay Vertalka 12:54

Yeah, it sounds like it should be simple and it's a hard thing sometimes to do. And this reframing and being able to change the nervous system takes practice. It's no different than learning to play an instrument. Uh, because you know, some of us are wired a certain way, and that's I'm kind of a sensitive person, and I can be wired kind of high. And that is, I think, why I like this topic of helping people who are dealing with chronic illness, because we're wired a certain way, but you can you can change your wiring a little bit through practicing new patterns that maybe are calmer. And Deb like you talked about the physiological change. You know, when we're stressed and anxious, you might have tight muscles and muscle tension. A lot of us carry it in our neck, it's called our upper trapezius muscles, and then that just can lead to a cascade of maybe neck pain or headaches. And you see again where you can get into a cycle. And so, coming back to what Deb was talking about, simple breathing can help relax muscles or help you be more mindful of where you're carrying your tension.

Deb Timmerman 14:08

So, in my experience, it doesn't work to use the tools after you have an accelerated pain flare, unless you've practiced that when you don't have it. Because it's hard for the brain to learn something new when it's already trying to defend its position of pain danger. So the key is learning to do breath tools throughout your day or as part of your day when you don't have a flare and teach the body that this pathway needs to connect so that when it comes up, you're prepared. You use the breath tool and it helps you relax because your body doesn't see that as something new. It's like, oh yeah, when you did that, I felt really good and I could relax. So it worked then, it's going to work now. So, you got to do a little bit of planning with some of this stuff. Same with reframing. I'm sorry, but when your ankles are killing you or when your knees are killing you, you're not thinking about how to get out of that. You have to have a backup plan beforehand and think about when I have this pain, I'm going to tell myself that this is temporary. I'm going to use my breath, I'm going to relax, I'm going to have a different pain experience. The brain starts to get that message, and it's not so hyper-reactive to what's happening. And then things start to moderate and calm down. So in our last podcast, Lindsay talked about this whole relationship between not wanting to move and knowing you need to move. And that's how you kind of get through that. It's by doing that practice work so that when you get to the point that you have to make a decision, your body already knows and it's not going to go to that feedback loop and reinforce that.

Lindsay Vertalka 16:09

Yeah. One of the um things I talk with patients about is gradually exposing our body to things, and that might be that might be a five-minute walk a day. And so doing a five-minute walk a day, even though it's maybe a little uncomfortable or it doesn't feel good, with time and with practice, your body and the nervous system learns that okay, I am safe. It might not feel good, but I'm safe and my alarm doesn't need to go off. And with time, the hope, and often what can happen is you can gradually increase that walking time. You know, maybe you start with five minutes and the next you gradually increase to 10 minutes, and then that we provide graded exposure to the nervous system to rewire.

Deb Timmerman 17:01

Yeah. And if you add a breath tool to that, it just helps to reinforce that positive feedback loop.

Lindsay Vertalka 17:12

Sure, Yeah, exactly.

Deb Timmerman 17:14

So it's hard to teach breath tools on a podcast. So this particular episode will be uploaded to the YouTube channel, and you can find that YouTube channel at the handle Less Stress in Life. If you put that into YouTube, it'll pop up. And I'll actually go through and guide you on that breath tool. I mean, we can try it here. So just starting to get your brain used to the idea of breathing. I use a technique called heart-focused breathing. It comes from the heart math family of tools, and heart-focused breathing goes like this. Focus your attention in the area of your heart. Imagine your breath flowing in and out of the center of your chest, middle of your heart, just breathing a little slower and deeper than usual. I like to refer to that as heart focus and heart breath. If you're used to breathing, doing belly breathing, this takes a little practice. And the way that I learned to do it was to put one hand on my belly and one hand on my heart and focus on the weight of the heat of that hand on my heart. And I had a hard time learning how to do this. I am not ashamed to say that I didn't start adding this technique until about six years ago, and I was teaching uh stress management tools long before that, and it made a huge difference in my pain experience, and it works great, but I had to practice. So starting with that may not be perfect the first time, but the more you learn how to do it, the easier it will come, and you get to the point where you can do that without having to think about it because your brain really does want to go to a point that it feels relaxed, it doesn't like to be in siege all the time, likes to be relaxed. So, we'll have that on the YouTube channel, and there will be a printout or a download that you can have the exercise with too. You can also Google heart math, heart focused breathing, lots of information out there. So there's tons and tons of use of this breath tool technique in many of the pain centers, like Scripps and Cleveland Clinic and Mayo. So this isn't something that's just made up, it's science-backed, works awesome. And if you'd like more information about how to use those tools, you can reach out to one of us on the Less Stress in Life podcast page. There's a place to send a message to us, and we'd be happy to talk you through that in a little bit more length. Anything else you think we need to add to this particular podcast, Lindsay? We talked a lot about a lot of science-y stuff today.

Lindsay Vertalka 20:26

Yeah, it's very complex. And Deb and I went to school for a long time to learn about this. So we're gonna try our best to teach you in a little bit more layman's terms, so it's not so confusing. Again, like Deb just talked about the breathing. I can relate, like it's not an easy practice. So the more you practice it, it does get easier. But I wanted to add, Deb, that we're gonna include in the show notes kind of a visual of what we're talking about, like this nervous system pain cycle and uh kind of how it can show up in your body and the different stress hormones that can contribute to this ongoing cycle that disrupts sleep and all the things. So uh we'll include that. Or if you want to just kind of Google pain cycle and look for images on the internet, that works too. There's a ton out there. But I think kind of as we close this, we want you to know that your body is not working against you, but it might be working over time to protect you. So, kind of one of the take-home messages, too, that we'll continue to talk about is the goal isn't to keep fighting your symptoms, but we want you to help you understand them and be able to slowly teach your nervous system that it's safe to turn that volume down on the alarm. Awesome. With that, we'll sign off and we'll see you next time. All right. See you next time .

Deb Timmerman 21:56

The Less Stressed Life podcast is for informational and educational. Purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Listening does not establish a provider-patient relationship. Always consult your physician or qualified health care provider with questions about your health or before making changes to your care. Do not delay seeking medical advice because of something you heard here. If you are experiencing a medical emergency, seek immediate care or call 911.