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Demystifying Predictive Coding: How Our Brain Handles Chronic Pain


Chronic pain is an ongoing, debilitating condition that affects millions of people worldwide. While the physical aspects of pain are well understood, the role of the brain in processing and maintaining chronic pain remains a subject of scientific exploration. One emerging theory, predictive coding, provides a fascinating perspective on how the brain interprets and perpetuates chronic pain. In this blog post, we will delve into the concept of predictive coding and its implications for understanding chronic pain.

The Basics of Predictive Coding

Predictive coding is a theoretical framework from neuroscience and cognitive science. It suggests that the brain is continually generating predictions about the sensory input it receives from the environment. These predictions are compared to the actual sensory input, and any discrepancies between the two are used to update and refine the brain's internal model of the world. This process occurs at multiple levels in the brain and is essential for perception and interpretation.

Predictive Coding in Normal Perception

In everyday life, predictive coding helps our brains make sense of the sensory information we encounter. For example, when we see a familiar object, our brain's predictive model allows us to quickly recognize it based on our prior experiences. This top-down processing is often accurate, making our interactions with the world efficient and seamless.

Predictive Coding in Chronic Pain

In chronic pain, predictive coding takes on a different role. When pain persists for an extended period, the brain's predictive model can become skewed. Here's how it works:

1. Altered predictions: In chronic pain, the brain may continuously predict the presence of pain, even when there is no external threat or damage. This ongoing prediction can lead to a heightened sensitivity to pain and an increased perception of discomfort.

2. Amplified feedback loop: When the brain's predictions are consistently inaccurate (i.e., it predicts pain when there is none), it can trigger a feedback loop that maintains the pain experience. The brain interprets this discrepancy as a sign of ongoing threat, which reinforces the chronic pain experience.

3. Central sensitization: Chronic pain can lead to a phenomenon known as central sensitization, where the nervous system becomes more responsive and overly active. Predictive coding plays a role in this process by continually predicting pain, thereby sensitizing the nervous system to even minor stimuli.

4. Psychological factors: Predictive coding in chronic pain is influenced by psychological and emotional factors, such as fear, anxiety, and stress. These emotions can amplify the brain's predictions of pain, further entrenching the chronic pain experience.

Implications for Treatment

Understanding predictive coding in chronic pain opens up new avenues for treatment and management. Therapies that target the brain's predictive processes, such as cognitive-behavioral therapy, mindfulness, and neurofeedback, can be beneficial in disrupting the feedback loop that perpetuates pain.

Moreover, interventions that address the emotional and psychological aspects of pain can help recalibrate the brain's predictive model. Techniques like relaxation, meditation, and pain education can assist in shifting the brain's focus away from pain, reducing its predictions, and ultimately diminishing the perception of chronic pain.


Predictive coding is a fascinating lens through which we can better comprehend chronic pain. It sheds light on how the brain's predictive processes can go awry, leading to the persistence of pain. By understanding these mechanisms, we can develop more effective and holistic approaches to managing chronic pain and improving the lives of those who suffer from it. Ultimately, the quest to unravel the mysteries of predictive coding in chronic pain may hold the key to more successful pain management strategies.

Contact us today for help with your journey out of pain. We help frustrated people living with chronic pain who are tired of suffering discover their individualized MPC Pain-Free Formula™ with the goal of recovery or significantly reducing pain so they can participate fully in life again. Let us help you rebuild after a chronic pain diagnosis even if it has been decades.

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Cynthia Austin, NBC-HWC


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