You were finally starting to feel hopeful. The chronic pain flares that had been ruling your life were becoming less frequent. You’d been diligent with your pain management routine, following every piece of advice, staying consistent with your treatments.
Then it happened. A pain flare-up that made you feel like you were knocked back to square one.
If this sounds familiar, I want you to know something important: chronic pain flares don’t always mean you’re doing something wrong.
In fact, they’re often a natural part of the healing process, even though it doesn’t feel that way in the moment.
As a therapist who has lived with chronic pain and now helps others navigate their healing journey, I understand the discouragement that comes with unexpected flares.
Today, I want to share some brain-based insights that may help you view these setbacks differently so you can respond to them with more compassion and understanding.
The Truth About Healing: It’s Not Linear
Here’s what I’ve learned from working with countless therapy clients dealing with chronic pain management: healing rarely happens in a straight line. Your brain and nervous system are incredibly complex, and the process of unlearning pain patterns takes time.
Chronic pain flares can happen even when you’re on the right healing path for several neurological and emotional reasons. Understanding these can help you ride the wave instead of panicking or abandoning what’s working.
Why Chronic Pain Flares Happen During Healing
When Your Brain Remembers Danger
Your brain is designed to protect you. If it once paired a specific movement, environment, or situation with danger, it may continue to sound the alarm long after the original threat is gone.
These conditioned pain responses work like emotional memories. A smell can trigger a vivid recollection, and similarly, certain situations can trigger pain flare-ups even when you’re making progress.
Common triggers include:
- Sitting at the desk where your pain first started
- Returning to a place where you were once bedridden
- Participating in activities you couldn’t complete because of pain
- Stressful situations that remind your nervous system of past difficulties
In pain reprocessing therapy (PRT), we work on helping your brain unpair these triggers through techniques like graded exposure and somatic tracking. The goal is to teach your nervous system that these situations are now safe.
Extinction Bursts: The Brain’s Last-Ditch Effort
This concept might be the most important thing you learn about chronic pain flares, and it’s something most people don’t know about.
When your brain starts unlearning a pain pattern, it doesn’t always fade quietly. Sometimes, the symptom spikes temporarily in what’s called an extinction burst. Essentially, this is your brain’s last-ditch effort to get your attention.
Think of it like this: if you’ve been responding to pain signals for months or years, your brain has learned that pain gets results (rest, attention, medical care, etc.). When you start changing your response to pain, your brain might temporarily increase the volume, thinking, “Wait! This usually works!”
This is frustrating and confusing, but it’s actually a sign that change is happening. Knowing about extinction bursts can help you stay the course instead of retreating when chronic pain flares happen during treatment.
The Perfectionism Trap
Many people dealing with chronic pain are highly driven individuals. They research extensively, follow protocols meticulously, and want to heal “correctly.”
But sometimes this creates its own pressure:
- Pressure to heal fast enough
- Pressure to do everything “right”
- Pressure to never have setbacks
This intense focus can ironically trigger the very pain flares you’re trying to avoid. Why? Because it activates your stress response, and your nervous system reads stress as danger.
Healing happens best when we feel safe, not perfect. Letting go of rigid rules around recovery can actually help your nervous system settle and reduce the frequency of flares.
When Pain Shifts and Moves
One of the most common things I see in my practice at DC Metro Therapy, is clients making progress with their original pain, only to have it show up somewhere else. The back pain becomes hip pain. The headaches become jaw tension. The stomach issues shift to neck problems.
This can feel alarming, like something new is wrong. But often, it’s actually a positive sign that your brain is letting go of the original pain circuit and your nervous system is recalibrating.
When we view these shifts as part of the healing process rather than proof that something’s broken, it helps reduce fear and reinforce safety. And that, in turn, often leads to less pain overall.
The Emotional Side of Pain Flares
Let’s talk about something that often goes unspoken: the emotional response to learning that pain can be brain-generated.
Many of my clients initially feel invalidated when they first hear about the mind-body connection in chronic pain management. Even when I emphasize that their pain is absolutely real, the message can feel like:
- “So this is all in my head?”
- “I’ve tried everything, and now I’m the problem?”
- “I’m being blamed for not getting better.”
Sometimes this frustration shows up as resistance to new approaches, even while asking for help. This isn’t defiance, it’s grief. Because if your pain is connected to your brain, that means it’s connected to your emotions, memories, and beliefs. That can feel vulnerable and overwhelming.
This is why I always emphasize: Your pain is real, and your brain and body are trying to protect you. But sometimes, that protection becomes a pattern that keeps you stuck.
When Chronic Pain Flares Typically Happen
In my practice, I’ve noticed that pain flare-ups tend to show up at very specific times:
After periods of progress – This is often an extinction burst, where symptoms spike as your brain unlearns old patterns
During emotional stress or life transitions – Even if the pain doesn’t seem “emotional,” your nervous system responds to all forms of stress
When putting pressure on yourself to heal perfectly – The stress of “doing it right” can paradoxically trigger symptoms
When environmental cues reactivate old memories – Conditioned pain responses that your nervous system hasn’t fully unlearned yet
How to Respond to Pain Flares Differently
The way you respond to a chronic pain flare makes all the difference. Instead of fear and frustration, try shifting toward curiosity and compassion.
Instead of: “Why is this happening? I was doing so well!”
Try: “This is uncomfortable, but flares are a normal part of healing. What might my nervous system need right now?”
Instead of: “I must be doing something wrong.”
Try: “This could be an extinction burst—a sign that my brain is actually changing.”
Instead of: “I’ll never get better.”
Try: “Healing isn’t linear, and this flare will pass like the others have.”
When your nervous system registers more safety and less panic around flares, they often lose their power and intensity.
Evidence-Based Approaches That Help
There are some really effective therapies that work directly with how your brain processes pain, and they can make a real difference in reducing chronic pain flares:
Pain Reprocessing Therapy (PRT) uses neuroscience principles to help retrain your brain’s pain pathways, teaching your nervous system to reinterpret pain signals as safe.
Emotional Awareness and Expression Therapy (EAET) helps you identify and express emotions that may be contributing to physical symptoms, calming your brain’s threat response.
Intensive Short-Term Dynamic Psychotherapy (ISTDP) targets unconscious defenses like perfectionism and emotional avoidance that can maintain chronic symptoms.
Moving Forward with Hope
If you’re experiencing chronic pain flares despite following all the “rules” or professional recommendations, please know that this doesn’t mean you’re failing or that healing isn’t possible.
At DC Metro Therapy, my team and I have seen countless clients who felt discouraged by unexpected flares, only to learn that these setbacks were actually part of their brain’s rewiring process.
Your brain is incredibly adaptable, and with evidence-based approaches like PRT and EAET, you can keep making progress even when you hit roadblocks along the way.
Remember:
- Flares don’t erase your progress
- Your response to flares matters more than the flares themselves
- Healing is possible, even if it doesn’t look like what you expected
The path forward does not require you to avoid or prevent any and all pain flare-ups. Instead, your approach can focus on changing your relationship with flare-ups and trusting in your body’s capacity to heal.
Ready to Shift Your Relationship with Pain Flares?
As someone who has lived through chronic pain myself and now specializes in the mind-body connection at DC Metro Therapy, I understand the frustration of doing everything “right” and still experiencing setbacks. The good news is that flares don’t mean you’re failing, and you don’t have to figure this out through trial and error.
Take Your Next Step Toward Chronic Pain Healing
Start with the on-demand webinar: “3 Steps to Healing Chronic Pain” gives you the neuroscience behind why your brain creates pain patterns and specific tools you can use immediately to begin your healing journey.
Go Deeper with the Course: “Calm Your Brain, Heal Your Pain” provides a complete framework for understanding extinction bursts, managing pain flares with compassion, and rewiring your brain’s pain pathways using proven Pain Reprocessing Therapy (PRT) techniques.
What you’ll gain:
- Tools to respond to flares with curiosity instead of panic
- Understanding of why extinction bursts are actually signs of progress
- Techniques to break free from the perfectionism trap that can trigger symptoms
- A compassionate approach to setbacks that supports your nervous system
Healing happens when you understand that flares are often part of the recovery process, not evidence of failure. When you can respond from a place of safety rather than fear, everything changes.
Need More Personalized Chronic Pain Therapy Support?
Ready to work one-on-one with someone who truly understands chronic pain? Contact us to learn about therapy sessions focused on chronic pain reprocessing and healing.
