Why does pain sometimes keep returning, even when nothing new has happened?

Why can the same condition feel completely different from one day to the next?

And why do stress, relationships, environment, expectations, past experiences, and the way we relate to our bodies affect pain?

Pain is more complicated than “something is wrong with the body.” It is also not just “in the brain,” but a whole-person experience. This page brings together what is known about the brain, nervous system, body, relationships, environment, stress, and neuroplasticity, and looks at what this means for people who live with pain that keeps coming back.

All Trauma Aware America posts about pain.

Why Homeostasis Matters More Than You Think

Most people don’t think much about homeostasis, but it’s the foundation of well-being. Homeostasis means the body and mind are in balance, able to meet life’s demands without burning out.

IPNB: A Superior Theoretical Model of Trauma, Chronic Pain, and Complex Stress

IPNB does not try to explain outcomes by isolating a single structure, pathway, or intervention and assigning it causal primacy. Instead, it offers a coherence model. It explains how patterns of experience emerge from the interaction of nervous system state, relational context, developmental history, and current conditions

Why Chronic Pain is So Exhausting

People often think of pain as something you should be able to push through if you’re determined enough. That isn’t how recurrent pain works.
When my pain is high, it changes everything. My attention is pulled toward it because my body has decided this is the most important thing happening. Reading becomes harder. Following conversations takes more effort. Planning, organizing, remembering what I was about to do, making decisions, even finding the right words can be surprisingly difficult. It isn’t because I’m lazy, unmotivated, or “not trying,” but because pain uses an enormous amount of my body’s resources.

Where Most Pain Books Go Wrong 

Even in otherwise groundbreaking or compassionate pain and trauma literature, it’s common for clinicians to bypass that many people with recurrent pain are still in danger or unsafety. Even when authors deeply understand the biology or psychology of pain, many fall into the trap of treating the individual nervous system as the central problem, rather than acknowledging the persistent social, medical, or relational harms that are still occurring and often causing or sustaining that pain. Here’s a look at how six prominent books tend to frame pain, and where they fall short from an Interpersonal Neurobiology (IPNB)-informed, context-aware perspective.

Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for chronic pain?

Cognitive Behavioral Therapy (CBT )aims to change thoughts and beliefs about pain. That can slide into telling people that their thinking produces their suffering. For someone in chronic pain, that easily turns into self-blame and pressure to “think better” while nothing in their life or body conditions improves. It also keeps attention focused on pain, which often intensifies it rather than settling it.
Acceptance and Commitment Therapy (ACT) reframes this by saying the pain can stay, and the work is to accept it and live anyway. That sounds kinder, but for chronic pain, it often becomes another demand placed on an already overburdened system.

Why I Won’t Call Pain “Banana”

Our brains and bodies need language that matches lived experience. If my body is screaming with pain but I’m told to call it “banana,” there’s a gap between what I feel and what I’m allowed to say. That mismatch creates more disconnection. Safety comes from being able to name the truth of experience and still be met with attunement, support, and respect.

Hopkins Pain Clinic Fail

In the fall of 2022, on insistence from a pain specialist, I was tangling with the healthcare system for access to a clinical consultation with the head of the Johns Hopkins Blaustein Pain Treatment Center. I wish I hadn’t.

You Don’t Heal Pain by Convincing Yourself That You’re Safe, but When Safety  Becomes Real

Pain does not always reflect tissue damage. Chronic pain often reflects a nervous system stuck in protection mode. That’s powerful knowledge.

Don’t Walk Away From Your Feet: The Hidden Cost of Pushing Through Foot Pain

Our culture glorifies pushing through pain. We treat our feet like tires on a car, expected to roll over rough terrain endlessly without care until they blow out. But our feet are intricate, living foundations composed of 26 bones, 33 joints, and over a hundred muscles, tendons, and nerves. When we ignore their distress signals, we are slowly laying the groundwork for severe, long-term physical and neurological breakdown.

Why a Doctor Visit Can Increase Our Pain

For someone with a chronic condition, going to the doctor can increase pain because the body is already in a heightened state of sensitivity. When pain persists over time, the nervous system adapts by becoming more responsive to potential threats, making even small stressors feel overwhelming. A doctor’s visit often involves factors that amplify this response.

Complex Regional Pain Syndrome (CRPS)

As one who has suffered from quadrilateral Complex Regional Pain Syndrome (CRPS) since 2006, I’ve had to learn how to cope and help relieve this difficult and extremely painful condition. Here’s my perspective on CRPS (Complex Regional Pain Syndrome) based on my understanding of trauma and neurophysiology.

CRPS and the Importance of Feeling Safe: An IPNB Perspective on Pain and Recovery

The sense of safety is deeply intertwined with the functioning of the nervous system, which plays a key role in conditions like Complex Regional Pain Syndrome (CRPS). IPNB emphasizes that our brains and bodies are relationally driven, meaning our experiences of safety or threat are not only influenced by internal processes but also by our interactions with others and our environment.

“The Suicide Disease” x 4

It is said that Complex Regional Pain Syndrome (CRPS) is “ranked among the most painful of all medical problems and has been nicknamed the ‘suicide disease’ because there is no cure and limited effective treatments. The pain from CRPS is so severe that it has been known to drive people to the brink of death. I have quadrilateral CRPS. That is, in all four limbs. Evidently this is uncommon. It is also a symptom of exceptionally traumatic lived experience combined with abysmal lack of necessary and appropriate social support.

Treating My CRPS and Becoming the Hunter Were the Same

For years I had CRPS in my feet and legs without knowing what it was. I wasn’t diagnosed until six years ago, but by 2016 it had become so severe that I cried when I walked. I also knew that if I stopped walking, my world would keep shrinking. So I walked every day.
At the time, I was renting a basement room from friends. Soon after I moved in, I realized the grocery store near their house was the same one where my father would shop. He had been a monster to me throughout my childhood and on into adulthood, and I realized there was a chance I might run into him there. Instead of avoiding that possibility, I made it my destination.

Restoring Homeostasis: How IPNB Can Inform CRPS Treatment

Complex Regional Pain Syndrome (CRPS) reflects how the mind, body, and environment are deeply interconnected. CRPS, particularly in its chronic form, illustrates how trauma—initially physical but often layered with emotional and social stress—can lead to persistent dysregulation within the nervous system. Here’s how IPNB would interpret and approach it.