One of the first conversations I have with my patients seeking help for their chronic pain is about reframing pain – something I’ve discussed in previous blogs here and here.

This foundational discussion is essential whether someone is searching for mindfulness for chronic pain, exploring pain neuroscience, or simply trying to understand why their pain persists despite doing “all the right things.”

This reframing creates space for a new relationship with the pain, something I’ve recently been describing as “nervous system threat reappraisal.”

It’s a mouthful, but it goes straight to the heart of what we are attempting to do when we practice mindfulness-based physical therapy: learning to notice sensations without judgment and becoming curious about what the nervous system is trying to signal.

So let’s unpack this idea a bit and see if we can’t make it more accessible than my usual “react differently” protocol from past posts.

Reappraising Painful Sensations as Safe and Approachable

You might be thinking to yourself: “Why on earth would I try to re-learn my pain as safe? It’s painful!”

And this is the exact right question to be asking – and easily one of the most common ones I explore with patients who come to my clinic for chronic pain treatment in Oak Park, IL.

When someone has been living with pain for many months or years, or when sensitivity begins to show up in ways unrelated to movement or position such as during stress, after certain foods, with poor sleep, or during weather changes, or when they carry diagnoses like fibromyalgia, chronic nonspecific low back pain, or failed back surgery syndrome, it often becomes necessary to look beyond the traditional biomedical model.

People usually search for explanations through imaging findings, sedentarism, or beliefs about misalignment. These ideas have helped many individuals and do hold value. Yet when pain becomes persistent, the picture grows larger. To understand, manage, and improve ongoing pain, we need a fuller view of the entire human system and how the brain and body co-create the pain experience. This broader perspective allows for responses that are more realistic, effective, and empowering.

However, when we take a deeper look at those who are experiencing chronic pain, we need to broaden our understanding of the whole human body and the pain experience, so we might have a more comprehensive and fuller grasp of how to properly respond and realistically manage (and improve) one’s pain.

Understanding Chronic Pain from a Nervous System Sensitivity Lens

Your nervous system is a living alarm system. When it senses danger (or expected danger), it produces rapid changes in the brain and body that move you away from harm and return you to safety. This protective response is one of the main reasons humans have survived for so long, especially before the comfort of modern environments (food, warmth, protection from the elements.)

Trouble arises when the nervous system begins to believe that danger is constant. When that happens, the threshold for triggering a protective response becomes lower. Pain can appear even when true physical threat is not present.

This idea is central to understanding many cases of chronic pain and it often becomes a powerful turning point for the people I work with. It offers a rational and grounded explanation for why pain can feel intense and limiting even when there is no tissue damage occurring.

How Mindfulness Helps Reappraise Pain

This understanding alongside mindfulness, somatic tracking, and other nervous system regulation practices help recalibrate an alarm system that has become overly protective.

If you experience your pain with nonjudgment (think: less habitual reaction of retraction, avoidance, or distraction) then your nervous system begins to relax and you start embodying safety from both a logical and experiential point of view.

This can be groundbreaking! Our habitual reactions are so automatic and quick that oftentimes we confuse our arising thoughts, emotions, and feeling tones as fact, when in reality, they are a culmination and result of our entire lived experience and our worldview leading up to that point. Once we gain new understanding, breathe, and create space between the sensation and reaction, then we might start to experience a new way of experiencing the pain, and, ultimately if continued to explore, life.

Research continues to show the effectiveness of mindfulness for chronic pain and nervous system regulation.

This study outlines the changes in the brain and the body and how short term meditation reduces pain and long term meditation changes the unpleasantness associated with pain.

This systematic review discusses how mindfulness influences pain perception by down-regulating threat, changing emotional intensity, and altering neural circuitry to decrease threat appraisal and reduce nervous system sensitivity.

This is just a small snippet compared to the growing library of studies that continue to espouse the various positive effects of mindfulness on lived experience as well as pain.

How this Integrates Into Physical Therapy

This is where Mindful Motion Physical Therapy truly stands apart. We bring together movement training and nervous system threat reappraisal so that pain becomes something you can understand and work with rather than fear.

Each session blends pain education, mindfulness based strategies, and graded physical therapy exercises. You learn how to interpret sensations with less threat, how to respond to discomfort with steadiness, and how to rebuild strong and confident movement patterns. This integration helps you fully inhabit your body in a safe and empowered way.

What emerges from this process is a set of sustainable practices that support real, lasting change. Patients often develop what I call swiss army like responsivity (maybe I need to think of a new name…) Regardless, it is a versatile, reliable internal toolkit that helps you meet sensations, stressors, and movement challenges with more clarity and control.

Realistic Expectations for Change

This is only one path toward reducing the suffering that surrounds pain. It is a powerful one with a rich history and growing evidence base, yet it remains just one approach among many. Pain may not disappear immediately, but the meaning of pain and your relationship to it can shift. That shift alone often leads people to places they could not have imagined when they first began.

As the sense of threat decreases, movement becomes easier, muscles begin to release long-held tension, and the fight or flight response gradually softens. Flares lose their ability to create fear. Recovery becomes quicker. I see this often in my patients. They begin to feel more capable, more confident, and more connected to their bodies.

When to seek a Mindfulness Based Physical Therapist in Oak Park

Mindfulness-based physical therapy can be especially helpful if you are struggling with pain that does not fully make sense within a traditional biomedical model. It may be time to explore this approach if:

• Your pain persists despite stretching, strengthening, chiropractic care, or medication

• Stress, sleep, food, or weather seem to influence your pain as much as movement does

• You notice fear of certain movements or worry about reinjury

• Your imaging does not match the severity of your symptoms

• You feel stuck between flare ups and periods of guarding

• You want a whole-person, research-informed approach that includes education, movement, and nervous system regulation

• You are ready to understand pain in a new way and build skills that support long-term change

Mindfulness-based physical therapy helps you work with your nervous system, not against it. It teaches you how to respond to sensation with steadiness and curiosity rather than alarm. And for many people, that becomes a turning point in their healing.