Know thy enemy (even if it’s your own knees)

Can learning about pain neuroscience lessen the pain? Possibly. Here's how.

Apr 19, 2026

Living with chronic pain is like having a car alarm attached to your body that goes off because a pigeon looked at it funny—it’s loud, exhausting, and most of the time completely unnecessary.

But a surprising method for helping people with chronic pain is gaining attention: neuroscience education. I’ve decided to try it out for myself. Here’s why.

Why I’m trading in despondency for scientific papers

I’ve lived with chronic pain for over 20 years, and in all that time, I’ve never really understood how pain works.

It was just something that was there, and far from wanting to understand it, I did everything I could to ignore it, distract myself from it, or wish it would just go away.

Which is understandable - there’s a reason why chronic pain sucks so bad, because pain is supposed to be temporary.

It evolved in our bodies for a purpose. It’s nature’s way of telling us that something is wrong. So that when we get some kind of injury, we know about it. We stop what we’re doing, we stop moving the part of our body that’s in pain, because pain is deliberately unpleasant, it’s very hard to ignore, it makes us alert, it stimulates our brain and our body to get our attention.

Normally, this is useful, because it means we attend to the injury, we heal, we get better, the pain goes away. If we’re walking around in the wild, and we cut our foot on a rock somewhere, if we didn’t know about it, that would be really bad - not knowing we were injured could actually kill us.

That’s why pain exists.

But when pain goes wrong (and there are lots of ways it can go wrong, as we spoonies know all too well), when it becomes chronic, those bodily reactions are no longer useful.

When pain is chronic, it still creates this alert, stressful emotional state, but it doesn’t help us - because by definition we have a chronic health condition which isn’t healing and going away.

It makes us feel like there is danger, there is something wrong. It has become mal-adaptive, meaning that it has become more harmful than useful. And this is what makes chronic pain so hard to live with, and why it contributes so much to our fatigue.

Can neuroscience education actually help chronic pain?

It’s possible that learning about how pain works can actually help.

I did a brief (very un-scientific) survey of recent medical journal papers on PubMed which asked the question “does learning about pain help”. 10 out of 11 random papers I read found some evidence that it does in fact help, and these papers studied a range of health conditions including fibromylagia, migraine, plantar fasciitis, chronic neck pain, spinal pain, and inflammatory arthritis. It’s unclear if the effect is long-lasting. See the references at the bottom if you’re interested in reading these yourself 1

Why is this?

Well, the thinking is basically this. When we feel pain, our natural, innate reasoning for this is that our bodies are actively being damaged, that our bodies are under attack, and this understandably creates a sense of fear, anxiety, it activates our fight or flight response, and in chronic pain this actually exacerbates the pain.

But in many chronic conditions, like with fibromylagia, the pain isn’t being caused by our bodies actually being damaged like they are when we break a leg or stub our toe.

And in other cases like in my condition, axial spondyloarthritis, there is some damage caused by the immune system attacking cells in my body, but due to something called central sensitisation the amount of pain I experience and the amount of damage that it feels like is happening is exaggerated quite far beyond what is actually happening.

According to my brain, a slightly inflamed joint is equivalent to a five-alarm fire in a fireworks factory.

So by learning why this is, by learning what is actually going on, and teaching our brains that it’s okay, you don’t need to be on high alert anymore, maybe chill out and relax a bit because we’re not being attacked, the pain itself isn’t a threat to our lives - research shows that people who learn about the neuroscience of pain actually feel less afraid of their pain, feel less anxious, feel like they are able to live more peacefully alongside their pain. And by learning that some chronic pain isn’t always caused by actual damage to your body, it can become easier to move and stretch and exercise.

I don’t know about you, but with axial spondyloarthritis, movement and exercise does help. But it’s just so hard to motivate myself when I’m tired and I’m in pain all the time. But just knowing that actually, the pain is being amplified by my brain and by moving I’m actually not damaging my joints, even though it feels like I am, is just a little extra thing that can help me decide - okay, yeah lets move a bit.

I should also point out that one study out of the 11 I looked at did not find that learning about pain helped, and some of the 10 that did showed only slight changes, which may be insignificant or temporary. So, it’s important to let go of any particular expectations of your pain significantly reducing or changing in any way by learning about pain.

But I can tell you this. I have found that it helps me personally to live with chronic pain, and many other people say the same.

Regardless of whether it actually effects our pain, I believe that if you live with chronic pain, it can be empowering to learn more about your condition, to learn the real science behind what’s going on in your body, because it makes you feel more in control, instead of pain being in control of you.

It also makes us better patients. When our doctors offer us a new treatment, or a new medication or exercise comes along, we’re better informed to make a decision about what’s right for us. It means we can take more of an active role in research, and understanding what scientists are doing so that, maybe for example we can help raise money for research into better pain relief for example. And it means that we can understand better why something like cognitive behavioural therapy can actually work.

And when you live with chronic illness, any advantage you can get is worth a try.