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Chronic pain is one of the most misunderstood and debilitating conditions in modern healthcare. Defined as pain that persists for longer than three to six months—or beyond the normal time of tissue healing—it affects millions of people. Yet, the standard medical model often fails these patients.
If you are reading this, you are likely familiar with the cycle. You have visited the GP, perhaps seen a specialist, and had the MRI scans. You have been told that your scan is “normal” for your age, or that the structural damage seen doesn’t explain the severity of your pain. You have been prescribed a cocktail of medications—Gabapentin, Amitriptyline, Codeine—that leave you feeling foggy, tired, and disconnected, but still in pain.
Eventually, many patients are handed the devastating sentence: “You just have to learn to live with it.” At Breakthrough Pain & Performance, we fundamentally reject this conclusion.
“Managing” pain implies that the pain is a permanent fixture, an uninvited guest that will never leave. Our approach is different. We do not just manage symptoms; we target the neurological root cause of chronic pain. We understand that persistent pain is rarely a problem with the tissues (muscles, bones, ligaments). It is a problem with the processing system (the brain and spinal cord).
By treating the nervous system directly, using advanced techniques like Proprioceptive – Deep Tendon Reflex (P-DTR) and functional neurology, we help patients retrain their brains, reduce their threat levels, and reclaim a life that is not defined by suffering.
To treat chronic pain, you must first understand that pain is an output, not an input.
When you injure yourself acutely—say, stepping on a Lego brick—your nerves send a “danger” signal (nociception) to the brain. The brain receives this signal, evaluates it, and produces pain to make you check your foot. This is a healthy, protective system.
In chronic pain, this system malfunctions. The volume knob on your pain system gets turned up and stuck. This is a phenomenon known as Central Sensitisation.
Inside your spinal cord, in an area called the Dorsal Horn, the nerves that carry danger signals synapse (connect) with the nerves that travel up to the brain. In Central Sensitisation, these synapses undergo a physical change. They become more efficient at transmitting danger signals. They sprout new receptors, making them “hungry” for input.
Eventually, the threshold for firing drops so low that inputs which should be safe—light touch, gentle movement, or even a change in temperature—are interpreted as dangerous. Your nervous system is amplifying the signal. You are feeling high-definition pain from a low-definition input. This is why mechanical treatments (massage, surgery) often fail in chronic cases; they are treating the foot, but the problem is in the amplifier in the spine and brain.
We often talk about Neuroplasticity as a good thing—it is how we learn languages or new skills. However, neuroplasticity is simply the brain’s ability to change based on what it practices. If you practice pain every day for five years, your brain becomes an expert at producing pain.
The neural pathways dedicated to pain become thick, fast superhighways. The areas of the brain dedicated to movement and sensation (the sensory and motor cortices) become “smudged.” The brain loses the ability to differentiate between the lower back and the hip, or the neck and the shoulder.
Because the brain’s map of the body is blurry, it perceives the body as unsafe. To protect you, it increases muscle tension and pain sensitivity. This creates a self-fulfilling prophecy: the pain prevents movement, the lack of movement blurs the map further, and the blurry map creates more pain.
Our treatment utilises Positive Neuroplasticity. We have to un-teach the brain. We use novel, non-threatening sensory inputs to show the brain that movement is safe. We flood the nervous system with “safety” signals that compete with the “danger” signals. Over time, with repetition and specific neurological drills, the pain highways atrophy (weaken) and the movement highways strengthen. We literally rewire the brain away from pain.
Chronic pain is rarely caused by one single thing. It is the result of Cumulative Load. We explain this using the Threat Bucket analogy.
Your nervous system has a bucket that collects stressors. These stressors can be:
In a healthy person, the bucket is half empty. They have the capacity to handle a bad day or a long walk. In a chronic pain sufferer, the bucket is brimming. It takes only a tiny drop—a cold draft, a stressful email, a short walk—to make the bucket overflow. The overflow is the pain flare-up.
Traditional medicine often tries to put a lid on the bucket (painkillers). We focus on opening the tap at the bottom. We act as detectives to find what is filling your bucket. It might be a surgical scar from 10 years ago that is still signaling “trauma” to the brain. It might be a visual issue that is stressing your neck. By identifying and resolving these hidden threats, we lower the water level in your bucket. This gives you a “buffer zone” so that normal life activities no longer tip you into pain.
You cannot talk about chronic pain without talking about inflammation. And you cannot talk about inflammation without talking about the gut.
The Gut-Brain Axis is a bidirectional communication line between your digestive system and your central nervous system, primarily mediated by the Vagus Nerve. If your gut is inflamed (due to processed foods, stress, or antibiotics), it releases pro-inflammatory cytokines into the bloodstream.
These cytokines cross the blood-brain barrier and activate the brain’s immune cells, the Microglia. When Microglia are activated, they release neurotoxins that irritate the surrounding nerves. This creates a state of Neuro-inflammation.
An inflamed brain is a hypersensitive brain. It perceives threat everywhere. It causes brain fog, fatigue, and widespread pain. Part of our chronic pain management involves looking at your metabolic health. We may guide you on how to reduce systemic inflammation through nutrition and hydration, cooling down the “brain on fire” and raising your pain threshold.
Standard pain management often teaches “pacing”—doing less to avoid flaring up. While preventing massive flare-ups is important, strict pacing can often lead to a shrinking world. You do less, so you become deconditioned. Your tolerance lowers. So you do even less. Eventually, you are housebound.
We advocate for Graded Exposure based on neurological safety. We find your “safe baseline”—what you can do today without paying for it tomorrow. Then, we use neurological treatments (P-DTR) to dampen the threat response associated with movement.
Once the brain feels safer, we nudge the baseline up. We don’t just pace; we expand. We prove to the brain, incrementally, that it is capable of more than it thinks. This rebuilds confidence and breaks the fear-avoidance cycle that keeps so many people trapped in chronic pain.
1. The Neurological Audit: We test your reflexes, your sensory processing, and your movement. We find the “energy leaks” in your system.
2. Receptor Reset (P-DTR): We identify specific mechanoreceptors (in scars, ligaments, or muscles) that are feeding the central sensitisation loop. We reset them using reflex techniques. This often provides immediate relief and increased range of motion.
3. Autonomic Regulation: We teach you how to switch your nervous system from a Sympathetic (fight/flight) state to a Parasympathetic (rest/repair) state. You cannot heal if you are stuck in fight/flight.
4. Resilience Training: We build your physical and neurological tolerance. We ensure that when you leave us, you have the tools to manage your own health and prevent relapse.
