Persistent pain isn’t just about the body tissues, it’s also about the brain’s predictions. Predictive processing shows us that pain is shaped by expectations as much and sometimes more than sensations. When the brain strongly expects pain, pain can be felt even without ongoing damage. The good news? By updating these predictions through education, mindfulness, safe movement, and context shifts, you can help your brain write a new, less painful story.

A groundbreaking study in Nature Medicine reveals chronic pain can be predicted before it spreads. Using data from 493,000 people, researchers created a six-question biopsychosocial risk score that forecasts pain progression up to 9 years in advance. The key drivers? Mood, sleep, stress, and BMI, not tissue damage. This is huge for informing how we understand and prevent persistent pain.

Listening plays a crucial role in effective persistent pain treatment, yet many clinicians interrupt within seconds of asking a question, missing valuable insights. Each person’s experience of pain is unique, and meaningful care begins with understanding their story. When time is short, choosing to listen well can still shape outcomes. The most effective treatment plans often start with the simplest intervention: giving space to be heard.