Just because it ‘hurts’ there… doesn’t necessarily mean the problem is there.

By Dr. Justin Lee, DC

I had a patient walk into my office last month who’d been to three different specialists in the past year. MRI? Clean. Physical therapy? Helped a little, then plateaued. Medications? Took the edge off but never really solved anything. She looked at me with exhausted eyes and said, “I feel like I’m going crazy. They keep telling me nothing’s wrong, but I’m in pain every single day.”

Here’s what nobody had told her: her back wasn’t the problem anymore. Her brain was.

After 8+ years in practice, I’ve seen this pattern more times than I can count. People come in expecting me to “fix their disc” or “crack their back into place.” And yes, structural issues matter—we’ll get to that—but there’s a layer most people (and honestly, most healthcare providers) completely miss: chronic pain literally rewires your nervous system.

A groundbreaking study just published in PAIN Reports (2025) is confirming what I’ve been observing clinically for years. The researchers found something remarkable: people with chronic lower back pain don’t just have different spines—they have different brain activity patterns. Not because they’re imagining the pain, but because pain changes how the nervous system processes information.

This isn’t just fascinating science. This fundamentally changes how we need to approach persistent pain.

What the Research Actually Showed (And Why It Matters to You)

The research team led by Keita Ueno studied 34 people with chronic low back pain and compared their brain activity to 34 people without pain. They used EEG technology to measure two crucial things:

1. Current Source Density – basically, how active different brain regions are
2. Functional Connectivity – how well different parts of the brain communicate with each other

Here’s where it gets interesting.

They found that people with chronic back pain showed significantly reduced communication between key brain regions—specifically in the beta frequency range (21.5-30 Hz). Think of it like this: your brain has different “departments” that need to talk to each other to process pain appropriately. In chronic pain sufferers, those phone lines weren’t working as well.

Even more revealing: they found that certain slow-wave brain activity (theta and delta waves) correlated directly with pain intensity. The more of this slow-wave activity in the prefrontal cortex, the worse the pain.

But the real kicker? One specific connection—between the right prefrontal cortex and right auditory cortex—showed a 0.62 correlation with pain intensity. That’s huge in research terms. The more “wired” those regions were, the worse people felt.

What this tells us: Your persistent back pain might not be perpetuated by ongoing tissue damage. It might be perpetuated by a nervous system that’s essentially stuck in “pain mode”—continuing to amplify signals long after the original injury has healed.

The Brain Regions Involved (And What They Actually Do)

The study identified specific brain areas with altered connectivity:

• Prefrontal Cortex: Your “executive control center”—handles attention, decision-making, and emotional regulation
• Posterior Cingulate Cortex: Part of your brain’s “default network”—active when you’re at rest, ruminating, or self-reflecting
• Temporal Gyrus: Processes sensory information and memory
• Inferior Parietal Lobule: Integrates sensory input and helps you understand where your body is in space

These aren’t random regions. These are the exact areas that determine how you experience and respond to pain.

When these regions aren’t communicating properly, your nervous system can’t accurately distinguish between actual threat and false alarm. The result? Pain that persists even when structural healing has occurred.

Why Your MRI Might Look Fine (But You Still Hurt)

This research helps explain something I see constantly in practice: the disconnect between imaging or other diagnostic findings and symptoms.

I can’t even begin to guess how many times people come in saying, “They said everything looks fine. But these issues still won’t go away.” Quite literally… hundreds of people have told me a similar story. I’m sure many of you have heard a similar thing!! (… Is that you??)

I’ve had patients with significant disc herniations who have minimal pain. I’ve had other patients with completely “normal” MRIs who are debilitated by pain. Why? Because pain isn’t just about structure—it’s about how your nervous system interprets that structure.

Think of it this way: your spine is like the hardware of a computer, but your nervous system is the software. You can have perfectly good hardware with glitchy software, or damaged hardware that the software has learned to work around. The key is addressing both.

This study demonstrates that in chronic pain, the “software” has developed bugs—altered connectivity patterns, disrupted communication between brain regions, and hypersensitive pain processing pathways.

From “Fixing the Disc” to “Rewiring the Network”

This is where modern chiropractic care diverges from the old-school “crack and go” model.

When I work with someone who has chronic pain, I’m not just thinking about spinal alignment (though that matters). I’m thinking about:

1. Sensory Input Quality Every joint in your spine has mechanoreceptors—sensory nerve endings that constantly feed information to your brain about position, movement, and stress. When joints are misaligned or restricted, that sensory input becomes distorted. It’s like trying to have a conversation with someone on a bad phone connection—the message gets scrambled.

Specific chiropractic adjustments don’t just “move bones.” They restore proper motion to restricted segments, which normalizes the sensory input flowing to your brain. Over time, this can help recalibrate those altered brain networks identified in the study.

2. Motor Output Your brain controls movement through the motor cortex, which has direct connections to the prefrontal regions implicated in this study. When we improve spinal alignment and movement patterns, we’re actually providing different input to these motor-planning regions.

This is why I always incorporate movement training and postural correction—not just passive adjustments. We’re retraining the brain-body connection.

3. Descending Pain Modulation Your brain has natural pain-control systems—descending pathways that can dampen or amplify pain signals coming from your body. Research shows these pathways weaken in chronic pain states.

Here’s the good news: restoring proper spinal function and nervous system input can help reactivate these natural pain-control mechanisms. We’re not just treating the back—we’re helping the brain remember how to manage pain appropriately.

4. The Upper Cervical Connection The upper neck (C1-C3 vertebrae) houses incredibly dense sensory input that feeds directly into the brainstem. This region influences everything from balance to pain processing to autonomic nervous system regulation.

I can’t tell you how many “low back pain” patients I’ve helped by addressing upper cervical dysfunction. Why? Because we’re addressing the neurological component, not just the structural one.

Beyond the Adjustment Table: The Complete Approach

Based on this research and my clinical experience, here’s what a comprehensive approach to chronic back pain should include:

Structural Correction

• Specific spinal adjustments to restore alignment and motion
• Address compensatory patterns throughout the entire kinetic chain
• Progressive corrective care, not just symptom chasing

Neurological Retraining

• Proprioceptive exercises (balance work, unstable surfaces)
• Sensorimotor integration drills
• Vision and vestibular training when appropriate
• Cross-body movements to engage both brain hemispheres

Movement Pattern Optimization

• Core stability training
• Hip mobility work
• Functional movement screening and correction
• Load management strategies

Lifestyle Factors That Influence Neural Networks

• Sleep quality: Fragmented sleep disrupts pain-processing networks
• Stress management: Chronic stress sensitizes pain pathways
• Nutrition: Inflammation directly affects nervous system function
• Breathing mechanics: Diaphragm dysfunction alters spinal stability and nervous system tone

The Questions You Should Be Asking

When someone tells you your pain is “in your head,” they’re not saying you’re imagining it. They’re saying your nervous system has adapted to chronic pain—and that’s actually good news, because it means we can work to change it.

Instead of just asking “Where does it hurt?” we need to ask:

• How is my nervous system processing this information?
• What sensory input am I giving my brain throughout the day?
• Are there movement patterns or postural habits reinforcing these pain networks?
• How’s my sleep, stress level, and overall nervous system health?

What This Means for Your Recovery

If you’ve been dealing with persistent back pain that hasn’t responded to conventional treatment, this research offers genuine hope. Your pain is real. Your nervous system has adapted. And with the right approach—one that addresses both structure AND neurology—you can retrain those altered networks.

This is why I spend 35-50 minutes on initial consultations. I need to understand not just where you hurt, but how your entire system is functioning. We take specific X-rays to identify structural issues. We assess movement patterns, postural habits, and neurological function. Then we create a comprehensive plan that addresses all the layers—not just “bad disc” or “tight muscle.”

The goal isn’t to manage your pain long-term. The goal is to restore optimal function so your nervous system can process pain appropriately, your brain networks can reconnect properly, and your body can do what it was designed to do: heal and adapt.

The Bottom Line

Pain is never just structural. It’s neuro-systemic.

When we only focus on discs and muscles, we miss the bigger picture—the brain networks that can perpetuate pain long after tissues have healed. But when we integrate structural correction with neurological retraining and nervous system optimization, we stop chasing symptoms and start creating real, lasting change.

If your back pain has been lingering despite “trying everything,” remember: you’re not broken. Your nervous system has adapted to chronic pain, and those adaptations can be reversed with the right approach.

Your spine matters. Your structure matters. But your brain—and how it’s wired to process pain—might matter even more.

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Ready to address the real cause of your pain?

Schedule a consultation at Minnetonka Family Chiropractic. Let’s look at the complete picture—structure, neurology, and function—and create a plan that actually gets you better.

Dr. Justin Lee, DC
Minnetonka Family Chiropractic
11349 MN-7, Minnetonka, MN 55305
(952) 229-8750
drjustinlee.com

Let’s get you moving and feeling like you’re supposed to.

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References:

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