Biography

David D. Clarke, MD is President of the Association for the Treatment of Neuroplastic Symptoms since 2011. He was Assistant Director at the Center for Ethics (2012–2025) and is Clinical Assistant Professor of Gastroenterology Emeritus, both at Oregon Health & Science University (OHSU) in Portland, Oregon, USA. He is also a Clinical Lecturer with Pacific University in Oregon and has been Associate Faculty at Arizona State University and the Cummings Graduate Institute.

He is board-certified in Gastroenterology and Internal Medicine and practiced Gastroenterology in Portland from 1984 to 2009. During that time, he diagnosed and treated over 7000 patients whose symptoms were not explained by diagnostic testing. In surveys of physicians by Portland Monthly magazine in the metropolitan area, Dr. Clarke was twice named one of the “Top Doctors” in his specialty. He has received numerous awards for patient care including the Distinguished Physician Award from Kaiser Permanente and an award from Pacific University for Outstanding Commitment to Physician Assistant Education.

His book for patients, They Can’t Find Anything Wrong! (Sentient Publications, 2007), was praised by a president of the American Psychosomatic Society as “truly remarkable.” It was also named one of the five best mind-body books ever written by Brit & Co. He was the lead editor for the professional textbooks Psychophysiologic Disorders (KDP Publishing, 2019), which has sixteen contributors from five countries, and the companion textbook A Diagnostic Guide for Psychophysiologic Disorders (KDP Publishing, 2022).

Dr. Clarke has lectured extensively on Neuroplastic Symptoms to health care professionals and the public across North America and in Europe. He has appeared on over 300 television, radio, and podcast interviews throughout the U.S. and was an Executive Producer of three documentary films about Neuroplastic Symptoms. His own podcast is titled The Story Behind the Symptoms.

Dr. Clarke is a graduate of Williams College (Phi Beta Kappa) and the University of Connecticut School of Medicine where he received the Mosby Award for Clinical Excellence. He completed internship and residency in Internal Medicine and fellowship in Gastroenterology at Harbor/UCLA Medical Center in Los Angeles. He has been a Visiting Professor at the Royal Children’s Hospital in Brisbane, Australia and at Oxford University in England. He was the Ethics Director for his medical group from 2000–2008.

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• Stressillness.com
• Press kit
• Podcast: The Story Behind the Symptoms

Curriculum Vitae

Current positions

• President, Association for the Treatment of Neuroplastic Symptoms (2011–present)
• Clinical Advisor, Stress Illness Recovery Practitioners Association, UK (2010–present)
• Clinical Lecturer, Pacific University (1997–present)

Education

• BA (Psychology), Williams College, Williamstown, MA (1971–1975), Cum Laude and Phi Beta Kappa
• MD, University of Connecticut School of Medicine, Farmington, CT (1975–1979)
• Internship and Residency, Internal Medicine, Harbor/UCLA Medical Center (1979–1982)
• Fellowship, Gastroenterology, Harbor/UCLA Medical Center (1982–1984)

Experience

• Gastroenterologist and Nutrition Support Director, Kaiser Permanente NW (1984–2009)
• Clinical Assistant Professor, Oregon Health & Science University (1990–2009)
• Sunnyside Medical Center Hospital Ethics Committee Chair (1999–2008)
• Ethics Service Director, Kaiser Permanente NW (2000–2008)
• Assistant Director, Center for Ethics, Oregon Health & Science University (2012–2025)
• Associate Faculty, College of Health Solutions, Arizona State University (2013–2022)
• Associate Faculty, Cummings Institute for Behavioral Health Studies (2015–2024)

Certifications

• National Board of Medical Examiners (1979)
• American Board of Internal Medicine (1982)
• American Board of Gastroenterology (1985)

Awards

• Mosby Prize for Excellence in Clinical Clerkships (1979)
• Vice-President, Joint Council of Interns & Residents of Southern California (1983–1984)
• NW Permanente Distinguished Physician Award (1990)
• NW Permanente Department of Gastroenterology Chair (1992–1995)
• Kaiser Quality Management Awards (two in 1993, two in 1995)
• Visiting Professor, Royal Children’s Hospital, Brisbane, Australia (1995)
• Visiting Professor, John Radcliffe Hospital, Oxford, England (1996)
• Kaiser Volunteer Award, Stress Medicine Clinic (1999)
• Top Doctor Award, Portland Monthly magazine (2005 and 2006)
• Outstanding Commitment to Physician Associate Education, Pacific University (2016)

Professional Association Memberships

• Academy of Consultation-Liaison Psychiatry
• Society for Biobehavioral Science and Medicine

Books

• They Can’t Find Anything Wrong! Sentient Publications, 2007
• Psychophysiologic Disorders (Clarke, Schubiner, Clark-Smith, Abbass), KDP Publishing, 2019
• A Diagnostic Guide for Psychophysiologic Disorders, KDP Publishing, 2022

Podcast, films & media

• Podcast: The Story Behind the Symptoms
• Executive Producer of the documentary films All The Rage (2016), This Might Hurt (2018), and Pain Brain (2023)
• Hundreds of TV, radio, and podcast interviews (2007–present) · Media coverage

Presentations

• Media presentations
• ATNS Q&A Member Webinars: two per month (virtual) since 2024
• April 23, 2026; Freedom from Chronic Pain lecture (virtual, Australia); 1615 – 1800
• April 23, 2026; University of Rochester virtual lecture; 1530 – 1615
• January 17, 2026; OHSU Internal Medicine Residents; 1000 – 1100
• December 17, 2025; OHSU School of Medicine Pain Intersession; 0800 - 1000
• December 9, 2025; OHSU School of Medicine Neuroplastic Lecture; 1430 – 1530
• December 5, 2025; NYU Langone Medical Center (virtual); 1000 – 1120
• November 3, 2025; ATNS White Paper Zoom presentation via Curable; 1000 – 1200
• October 10, 2025; National Psychology Training Consortium; Seattle; 1300 – 1630
• September 28 & 30, 2025; ATNS Conference; Boulder, CO; two 1-hour presentations
• September 10, 2025; Living Proof Seminar; 1030 – 1200
• August 21, 2025; OHSU School of Medicine Pain Intersession; 1000 - 1200
• August 18, 2025; OHSU School of Medicine Pain Intersession; 1400 - 1600
• August 12, 2025; OHSU School of Medicine Neuroplastic Lecture; 1300 – 1400
• August 6, 2025; KUMC IM/Psychiatry Residency; Kansas City, KS (virtual); 1200 – 1300
• July 29, 2025; Chaminade University; Honolulu, HI (virtual); 0900 – 1100
• July 23, 2025; OHSU Internal Medicine Residents; 1000 – 1100
• July 16, 2025; Pacific University Physician Associate program; 0900 - 1200
• June 18, 2025; OHSU Internal Medicine Residents; 1000 – 1100
• June 13, 2025; Williams College Reunion Keynote Speech; 1000 – 1100
• April 18, 2025; University of Rochester webinar; 1200 – 1300
• March 19, 2025; OHSU Internal Medicine Residents; 1000 – 1100
• March 14, 2025; OHSU Medical Psychology dept; 1200 – 1300
• March 5, 2025; Stichting Emovere (Netherlands) webinar; 1000 – 1100
• February 26, 2025; OHSU Internal Medicine Residents; 1000 – 1100

Publications

• Clarke DD, Kao HW. Meaningful markers for hepatitis Dx and Px. Contemporary OB/GYN, May 1983: 31–50
• Clarke DD, Kao HW. How to interpret hepatitis markers. Diagnosis, June 1983: 67–73
• Clarke DD. Letter. Annals of Internal Medicine 99:875, 1983
• Clarke DD, Snape WJ. Pinpointing troublesome diverticula in the colon. Contemporary OB/GYN, May 1984: 119–121
• Clarke DD, Bhasker M, Snape WJ. Use of a different computer logic to analyze colonic myoelectric activity in diverticular disease of the colon. Gastroenterology 86:1049, 1984
• Hyman PE, Clarke DD, Everett SL, Sonne B, Stewart D, Harada T, Walsh JH, Taylor IL. Gastric acid secretory function in pre-term infants. Pediatrics 103:467–471, 1985
• Snape WJ, Clarke DD, Gautsch E. Effect of cisapride on colonic smooth muscle in vitro (abstract). Gastroenterology 88:1592, 1985
• Clarke DD. Letter. Gastrointestinal Endoscopy 33:264, 1987
• Suchowiecky M, Clarke DD, Bhasker M, Perry RJ, Snape WJ. Effect of secoverine on colonic myoelectric activity in diverticular disease of the colon. Digestive Diseases and Sciences 32:833–840, 1987
• Clarke DD. Letter. American Association of Individual Investors Journal XII:4, 1990
• Clarke DD. Lecture: Expanding Professionalism in Practice. Gastroenterology and Endoscopy News 45:32–33, Jan 1994
• Clarke DD. Domestic Violence: Perspective of a Gastroenterologist. NWP Journal of Clinical Practice 2:39–40, Dec 1995
• Clarke DD. An Approach to Severe or Persistent Functional Symptoms. The Permanente Journal Vol. 1 #2: 15–18, Fall 1997
• Clarke DD. Letter. Permanente Journal Vol. 2 #3: 76, Summer 1998
• Clarke DD. Functional Gastrointestinal Symptoms: A New Approach Using a Stress Illness Diagnosis Clinic. Clinical Perspectives in Gastroenterology 2:40–46, Jan–Feb 1999
• Lehnert ME, Clarke DD, Gibbons JG, Ward LC, Golding SM, Shepherd RW, Cornish BH, Crawford DH. Estimation of body water compartments in cirrhosis by multiple-frequency bioelectrical-impedance analysis. Nutrition 17(1):31–34, Jan 2001
• Clarke DD. The 79 Year Illness. The Permanente Journal Vol. 6 #4: 27, Fall 2002
• Clarke DD. They Can’t Find Anything Wrong! Sentient Publications, October 2007
• Edwards TM, Stern A, Clarke DD, Ivbijaro G, Kasney LM. The treatment of patients with medically unexplained symptoms in primary care: a review of the literature. Ment Health Fam Med 7(4):209–221, 2010
• Clarke DD. Book review: The Lived Experience of Violation: How Abused Children Become Unhealthy Adults by Anna Luise Kirkengen, MD PhD. The Permanente Journal Vol 15 #1: 93, Winter 2011
• Clarke DD. The Scarlet Letter: Excerpt and Commentary. Academic Medicine 87(8):1084–5, August 2012
• Ivbijaro G, et al. Companion to Primary Care Mental Health, Chapter 33: Multimorbidity in Primary Care Mental Health. Wonca and Radcliffe Publishing, 2012
• Clarke DD. Solving Medical Mysteries: Hidden Stresses and Unexplained Symptoms. Slovenian Journal of Public Health 55(3):152–154, Sep 2016
• Clarke DD. Diagnosis and treatment of medically unexplained symptoms and chronic functional syndromes. Families, Systems, & Health 34(4):309–316, Dec 2016. DOI
• Clarke DD. Childhood Disrupted review: How your biography becomes your biology, and how you can heal. Perm J 2017;21:16-039. DOI
• Clarke DD. Solving Medical Mysteries: Hidden Stresses and Unexplained Symptoms. ATTACHMENT: New Directions in Psychotherapy and Relational Psychoanalysis Vol 11/3, Dec 2017: 242–253
• Olde Hartman TC, Lam CLK, Jinan U, Clarke D, Fortes S, Dowrick C. Addressing the needs of patients with medically unexplained symptoms: 10 key messages. Br J Gen Pract 68:442–443, Sept 2018. DOI
• Edwards TM, Dowell A, Clarke D, Gangolli VR, Patterson JE. Psychological Interventions in Older Adults. In Primary Care Mental Health in Older People (Lima CA deM & Ivbijaro G, eds.), Chapter 10: 111–126. Springer, 2019
• Olde Hartman TC, Dowrick C, Lam CLK, Fortes S, Clarke D, Usta J. Medically Unexplained Symptoms. In Global Primary Mental Health Care: Practical Guidance for Family Doctors (Dowrick C, ed.), Chapter 4: 55–74. Routledge, 2020
• Ganzel B, Kusmaul N, Cheatham C, Clarke D. Trauma-informed long-term care. In Managing the Long-Term Care Facility: Practical Approaches to Providing Quality Care (Perley R, ed.), 2nd Edition, Chapter 3. John Wiley and Sons, 2020
• Clarke D, Sondag M, Goldberg MH, Gustafson A. How Americans Experience and Understand Neuroplastic Symptoms. Association for the Treatment of Neuroplastic Symptoms, Portland, OR, 2025. DOI
• Clarke D, Gustafson A, Goldberg MH. Why Do Many People Struggle to See Their Own Neuroplastic Symptoms? Association for the Treatment of Neuroplastic Symptoms, Portland, OR, 2026. DOI

Hear from someone who recovered

What is fibromyalgia, and what causes it?

Fibromyalgia is widespread pain and tenderness throughout the body, usually alongside deep fatigue, unrefreshing sleep, and trouble with focus and memory. The pain can move, flare, and ease for no clear reason. Blood tests and scans come back normal, which is part of what makes it so exhausting to live with and so often misunderstood.

For a long time, no one could say what caused it. Now the research points to an answer. In many people, fibromyalgia is neuroplastic. The brain and nervous system have learned to send pain signals and keep them switched on, even though the body itself is healthy. The pain is real. It isn't imagined, and it isn't a sign that something is wrong with your body. It comes from altered nerve pathways and those pathways can change.

Can stress or emotions cause fibromyalgia?

Yes, and it doesn't mean the pain is in your head. Stress and strong emotion set off the same danger response in the brain that produces physical pain, and for some people that response gets stuck. It can be set off by pressure you're under now, or by difficult experiences from the past that your nervous system never fully overcame. This is a protective response, not a weakness or a character flaw. It also isn't the whole story for everyone, which is why the goal is to calm the pathway, not to blame yourself for it.

The symptoms

Fibromyalgia rarely shows up as one thing. Most people have several of these at once, and each can be part of the same neuroplastic pattern:

• Widespread muscle and joint pain, often aching or burning, that moves around the body or shifts from day to day.
• Foot pain, including heel and arch pain that can look like plantar fasciitis but doesn't improve with the usual treatments.
• Deep fatigue that rest doesn't fix.
• Unrefreshing sleep, waking up as tired as when you went to bed.
• Brain fog, trouble concentrating or finding words.
• Heightened sensitivity to touch, pressure, light, sound, or temperature.
• Flares that come and go with stress, weather, activity, or strong emotion.

One set of clues points toward a neuroplastic cause more than any single symptom: pain that moves, flares with stress, spreads beyond what an x-ray can explain, or hasn't responded to treatments aimed at the body. If that sounds familiar, a short self-assessment can help you tell.

Fibromyalgia often comes with other symptoms

If you recognized more than one symptom above, you're not alone. Most people with neuroplastic symptoms have several at once, and it can feel like a pile of separate problems. Fibromyalgia often travels with headaches, digestive trouble, and conditions like complex regional pain syndrome. Usually they trace back to one underlying cause that is treatable.

There's a better way to treat fibromyalgia

Most people with fibromyalgia are handed medications to manage symptoms, told to lower their stress, and to live with it. Some of that can bring relief for a while, and there's no shame in having tried it. But when the cause is neuroplastic, treatment aimed only at the body tends to fall short, because it isn't reaching the cause of the symptoms.

Neuroplastic recovery therapies work at the source, the learned signals in the brain. The two ATNS emphasizes are both backed by randomized controlled trials:

• Pain Reprocessing Therapy (PRT) teaches the brain to read the pain as safe, so the danger signal can switch off.
• Emotional Awareness and Expression Therapy (EAET) helps you recognize and release the stress and emotion the nervous system has been holding.

Is fibromyalgia curable?

Here's the honest, hopeful version. When fibromyalgia is neuroplastic, recovery is common, and many people become free or nearly free of their symptoms rather than just managing them. Because these pain pathways are learned, they can be unlearned. Recovery usually isn't a straight line, and it helps to start after a doctor has ruled out other conditions. But the relief most people are told is impossible is the one the research keeps showing.

Did you know?

• About 1 in 3 adults, over 80 million Americans, experience neuroplastic symptoms. (ATNS national survey, 2025.)
• In one study of people with years of chronic pain, two out of three were pain-free or nearly pain-free after Pain Reprocessing Therapy, and the results held five years later. (Ashar et al., 2021 & 2025, JAMA Psychiatry.)
• For chronic musculoskeletal pain, Emotional Awareness and Expression Therapy far outperformed cognitive behavioral therapy. (Yarns et al., 2024, JAMA Netw Open.)
• For fibromyalgia, Emotional Awareness and Expression Therapy outperformed the education group and had some advantages over CBT for pain relief. (Lumley, M.A. & Schubiner, H., et al, 2017. Pain).

Hear from someone who recovered

What is chronic fatigue syndrome, and what causes it?

Chronic fatigue syndrome (ME/CFS) is a serious, long-term illness whose main feature is profound fatigue that isn't relieved by rest and gets worse after physical or mental effort. It often comes with unrefreshing sleep, brain fog, dizziness on standing, pain, and a heightened sensitivity to light, sound, and exertion. It frequently begins after a viral infection, and standard tests usually come back normal, which is part of why people spend years without answers.

That normal result points toward what's really happening. In many people, ME/CFS involves a nervous system that got stuck in a threat state, often after an infection or a long stretch of stress, and kept the body in a protective, shut-down mode long after the original trigger passed. This is not the same as being deconditioned or out of shape, and it is not a matter of willpower. The exhaustion is real and physical. Because it comes in part from learned nervous-system patterns, those patterns can change.

Can stress or emotions cause chronic fatigue?

It's more accurate to say stress and the nervous system can help keep it going, and naming that is not saying the illness is in your head or that you brought it on. Infections, stress, and strong emotion all run through the same danger system, and when that system stays switched on, it can hold the body in the fatigue and crash cycle. Recognizing that link is not blame. It's the opening to treatment, because a nervous system that learned this state can be helped to unlearn it.

The symptoms

Neuroplastic chronic fatigue can show up as:

• Deep, ongoing fatigue that rest and sleep don't fix.
• Post-exertional crashes, where symptoms flare hours or days after even small physical or mental effort.
• Unrefreshing sleep, waking up as tired as you went to bed.
• Brain fog, trouble with focus, memory, and finding words.
• Dizziness or a racing heart on standing, and sensitivity to light, sound, and exertion.
• Symptoms that flare with stress and ease during safer, calmer stretches.

A clue it may have a neuroplastic component: symptoms that fluctuate, followed an infection or a stressful period, come with other unexplained symptoms, and haven't responded to treatment. A short self-assessment can help you tell.

Chronic fatigue often comes with other symptoms

ME/CFS rarely travels alone. It overlaps heavily with Long COVID, and often comes with widespread pain, digestive trouble, and dizziness. If you have several symptoms at once, they may share a single, treatable nervous-system pattern.

There's a better way to treat chronic fatigue

There's no simple cure offered in most clinics, and people are often left to manage symptoms alone. Anything that pushes the body past its limits, like being told to just exercise more, can make ME/CFS worse, so this has to be approached gently. There's no shame in whatever you've leaned on to get through.

Neuroplastic recovery works by helping the nervous system feel safe again, so it can come out of its protective shutdown at a pace the body can handle. Pain Reprocessing Therapy (PRT) and Emotional Awareness and Expression Therapy (EAET) lower the brain's threat response, and gentle, pacing-aware approaches help the system rebuild capacity without triggering crashes. This works alongside medical care, not in place of it, and should be started with a clinician.

Can chronic fatigue syndrome be cured?

The honest answer is hopeful and careful. Many people substantially recover, especially when a neuroplastic, nervous-system component is part of the picture and it's addressed gently. Recovery varies more than with milder conditions, and it should be pursued with a clinician, but a fuller life is a realistic goal, not a false promise.

Did you know?

• Fatigue was one of the most common symptoms reported in the ATNS national survey, named by about 32% of people with ongoing symptoms. (2026 ATNS national survey.)
• About 1 in 3 adults experience neuroplastic symptoms of some kind. (ATNS national survey, 2025.)
• Across chronic symptoms, most people improved substantially after neuroplastic recovery therapy. (Ashar et al., 2021 & 2025; Donnino et al., 2021.)

Hear from someone who recovered

What is vertigo, and what causes it?

Vertigo is the sense that you or the room is spinning or tilting. Dizziness is broader, a feeling of being unsteady, lightheaded, or off-balance. Both can come with nausea, visual strain, and fear of the next attack. Sometimes there's a clear medical cause, like an inner-ear problem, which a doctor should check. But for many people the workup comes back clear, and the dizziness continues anyway.

When that happens, the cause is often neuroplastic. Balance depends on the brain constantly blending signals from the inner ear, the eyes, and the body. Under sustained stress, the brain can start reading those signals as threatening and generate dizziness as a kind of false alarm. The sensation is completely real. It's coming from an overprotective nervous system, not from damage a scan would show.

Can stress cause vertigo and dizziness?

Yes. This is one of the most common questions people ask, and the answer is a clear yes. Stress and anxiety put the brain's danger system on high alert, and for some people that shows up as vertigo, dizziness, or a constant sense of imbalance. You might notice it flares during stressful stretches and eases when things calm down. That pattern doesn't mean you're imagining it. It means the symptom is neuroplastic, and that's exactly the kind that responds to retraining.

The symptoms

Neuroplastic vertigo and dizziness can feel like:

• A spinning or tilting sensation (vertigo), or a general unsteadiness or lightheadedness (dizziness).
• A feeling of floating, rocking, or being off-balance, even while sitting still.
• Symptoms that flare with stress, busy visual environments, or fatigue.
• Nausea or visual strain alongside the dizziness.
• A fear of the next episode that can make it worse.

A telling sign it may be neuroplastic: the dizziness flares with stress, moves or changes, and hasn't responded to treatments aimed at the inner ear. A short self-assessment can help you tell.

Vertigo often comes with other symptoms

Dizziness rarely travels alone. The same nervous-system pattern can bring headaches, fatigue, or other unexplained symptoms at the same time. If you have more than one, they may share a single, treatable cause.

There's a better way to treat vertigo

Vertigo is often treated with medications, balance exercises, or repositioning maneuvers, which are the right first step when there's an inner-ear cause. But when the workup shows no injury or disease and the dizziness persists, treatment aimed at the nervous system can reach what those approaches can't.

Neuroplastic recovery therapies retrain the brain to read balance signals as safe again. Pain Reprocessing Therapy (PRT) applies the same principle used for pain, lowering the threat the brain attaches to the sensation. Emotional Awareness and Expression Therapy (EAET) eases the underlying stress that keeps the alarm on.

Can neuroplastic vertigo go away?

Yes. When dizziness comes from a learned nervous-system pattern rather than structural damage, the brain can unlearn it, and many people recover. It usually helps to work with a clinician, especially to rule out inner-ear causes first, but lasting relief is a realistic goal.

Did you know?

• About 1 in 3 adults experience neuroplastic symptoms. (ATNS national survey, 2025.)
• Dizziness that persists after a normal workup is common, and often reflects a nervous system stuck on alert rather than a structural problem.
• Across chronic symptoms, most people improved substantially after neuroplastic recovery therapy. (Ashar et al., 2021 & 2025; Donnino et al., 2021. Yarns et al., 2024)

Hear from someone who recovered

What is neuroplastic back pain, and what causes it?

Back pain is one of the most common reasons people see a doctor, and one of the most commonly misunderstood. Many people are told an x-ray or MRI finding, like a bulging disc or mild arthritis, is the cause. But those findings are just as common in people with no pain at all, so they often don't explain the pain, especially when it's severe or long-lasting. This includes upper, mid, and lower back pain, and sometimes pain that runs down the back of the leg as sciatica.

When back pain persists past the few months an injury should take to heal, or the tests don't explain it, the cause is often neuroplastic. The muscles tighten and the pain fires because the brain's danger system has learned to stay switched on, not because there's ongoing damage. The pain is real. It's produced by nerve pathways that can be retrained.

Can stress cause back pain?

Yes, and it's more common than most people realize. Stress, trauma, unrecognized emotions, and other life challenges can set off the brain's danger response. The back is one of the most common places it shows up, as tightness, spasm, or pain in the lower or upper back. You might notice your back pain gets worse during stress, before a big event, or when you're carrying more than you let on. That doesn't mean the pain is in your head. It means the pain is neuroplastic, and treatable.

The symptoms

Neuroplastic back pain can show up as:

• Lower, mid, or upper back pain that lingers longer than an injury should, or that no x-ray or MRI fully explains.
• Muscle tightness or spasm that flares with stress.
• Pain that moves around the back or shifts side to side.
• Flares tied to stress, emotion, or other life challenges more than to specific movements.
• Pain that eases when you're absorbed or relaxed and returns when you are not.

The clearest sign it may be neuroplastic: pain that moves, flares with stress, outlasts the healing timeline for physical injury, is not always triggered by the same movements, or hasn't responded to treatment aimed at the spine. A short self-assessment can help you tell.

Back pain often comes with other symptoms

Back pain is often accompanied by neck pain, digestive trouble, headaches, or fatigue at the same time. The more symptoms you have and the more they differ in location, the more likely it is that they share a single, treatable cause.

There's a better way to treat back pain

Most back treatment focuses on the spine through physical therapy, medication, injections, nerve blocks, devices, and sometimes surgery. Some of that brings relief for a while, and there's no shame in having tried it. But when the cause is neuroplastic, treatment aimed only at the spine tends to fall short, because the pain is coming from the brain's learned signals.

Neuroplastic recovery therapies work where the pain starts. Pain Reprocessing Therapy (PRT) teaches the brain to understand that your back is safe, so you can shift attention to the distress that your mind is trying to communicate. Emotional Awareness and Expression Therapy (EAET) uncovers the stress and emotion feeding the pattern. That enables you to put these issues into words so they no longer need to be expressed via the body in the form of symptoms. Careful studies at leading research centers across North America have shown remarkable improvement from this approach.

Is back pain curable?

For neuroplastic back pain, yes, recovery is common, and many people become pain-free rather than just managing it. In one landmark study of people with years of chronic back pain, two out of three were pain-free or nearly pain-free after Pain Reprocessing Therapy, and the results held five years later. Recovery is realistic, especially once a doctor has ruled out the less common structural causes.

Did you know?

• In the Boulder back-pain study, two out of three people with an average of ten years of chronic back pain were pain-free or nearly pain-free after one month of Pain Reprocessing Therapy, versus 20% on placebo, and the results held at five years. (Ashar et al., 2021 & 2025, JAMA Psychiatry.)
• In chronic back pain, neuroplastic pain is much more common than structural pain. (Schubiner et al., 2023, Journal of Pain.)
• Many x-ray and MRI findings blamed for back pain, like bulging discs, are very common in people with no pain at all. (Brinjikji W et al., 2015, Am J Neuroradiology)

Hear from someone who recovered

What is IBS, and what causes it?

Irritable bowel syndrome is ongoing abdominal pain, cramping, bloating, and changes in how often and how urgently you go, that can be constipation or diarrhea or swing between both. It's diagnosed when tests rule out other conditions, and it can feel dismissive to hear, "everything looks normal."

That normal result is actually a clue. IBS is one of the clearest examples of the brain-gut connection. The gut has its own dense network of nerves in constant conversation with the brain. Under sustained stress, that conversation can get stuck in a state of alarm, and the gut becomes hypersensitive and reactive. The resulting pain and urgency are completely real. But they are coming from an oversensitized brain-gut pathway, not from damage an endoscope would find.

Can stress cause IBS?

Yes, and it's one of the most common questions about IBS for good reason. Stress and emotion travel straight to the gut through the same danger system that produces other neuroplastic symptoms, which is why flares so often line up with difficult weeks, big events, or anxiety. It doesn't mean you're imagining it or that it's in your head. It means the symptoms are neuroplastic, and that's the kind that can be retrained.

The symptoms

Neuroplastic IBS can show up as:

• Abdominal pain and cramping that can be severe, and that eases and returns.
• Bloating and urgency, sometimes with a fear of being far from a bathroom.
• Constipation or diarrhea or swings between both.
• Flares that track with stress or emotion more than with any single food.
• Symptoms that quiet during calm, absorbed stretches and return under pressure.

A telling sign it may be neuroplastic: symptoms that flare with stress, shift over time, and persist after tests come back clear. A short self-assessment can help you tell.

IBS often comes with other symptoms

IBS rarely travels alone. The same nervous-system pattern often brings pelvic pain, fatigue, headaches, muscle pain or other unexplained symptoms at the same time. If you have more than one, they may share a single, treatable cause.

There's a better way to treat IBS

IBS is usually managed with diet changes, fiber, and medications, which can bring relief and are worth using when they help. But when the cause is a learned brain-gut pattern, treatment that targets that pattern can reach what diet and medication can't.

Neuroplastic recovery therapies retrain the brain-gut connection so it stops sounding the alarm. Pain Reprocessing Therapy (PRT) lowers the threat the brain attaches to gut sensations. Emotional Awareness and Expression Therapy (EAET) uncovers and eases the often unrecognized stress and emotion feeding the flares.

Is IBS curable?

For neuroplastic IBS, meaningful and lasting relief is a realistic goal, and many people become free or nearly free of symptoms rather than merely managing them. Because the pattern is learned, the brain-gut connection can be retrained. This is well worth trying after a clinician has ruled out other conditions.

Did you know?

• About 1 in 3 adults experience neuroplastic symptoms, and digestive symptoms are among the most common. (ATNS national survey, 2025.)
• 26% of people in the ATNS national survey reported digestive or bowel problems among their symptoms. (2025 ATNS national survey.)
• Across chronic symptoms, most people improved substantially after neuroplastic recovery therapy. (Donnino et al., 2021; Ashar et al., 2021 & 2025. Yarns et al, 2024.)

Hear from someone who recovered

What is chronic pain, and what causes it?

Pain is called chronic when it lasts beyond the time an injury should take to heal, usually a few months. It can stay in one place or move, have steady intensity or flare, and often it no longer matches anything an x-ray can find. Living in constant pain is exhausting, and being told the tests look normal is very frustrating.

Here's what changes everything: all pain is produced by the brain. Usually it's responding to a damage signal from the body. But when pain becomes chronic, it's often because the brain's danger system has learned the pain pathway and keeps it switched on, long after any injury has healed. This is neuroplastic pain, and it's the most common type of chronic pain. The pain is real. But it's coming from a nervous system stuck on alert. Fortunately, that can change.

Can stress cause chronic pain?

Yes. Stress (sometimes from the past), strong but unrecognized emotions, trauma, and other challenging experiences set off the same danger response in the brain as a physical injury, and over time that response can get stuck. It's why chronic pain so often flares during stressful times and eases when life calms down. That link doesn't mean the pain is in your head. It means it's neuroplastic, and treatable.

The symptoms

Chronic pain is different for everyone, but a few patterns point toward a neuroplastic cause:

• Pain that has lasted longer than an injury should take to heal.
• Pain that moves around the body, or comes and goes.
• Flares tied to stress, weather, or certain people, situations, or events.
• X-rays and other tests that come back normal, or don't explain the pain you're in.
• Pain that has not responded as expected to treatments aimed at the body.
• More than one symptom at once, especially if in different body locations.

These patterns indicate the fear-pain cycle is at work: pain triggers fear, fear keeps the brain on alert, and the alert keeps the pain going. Breaking that cycle is a big part of recovery. A short self-assessment can help you tell whether your pain fits the pattern.

Chronic pain often comes with other symptoms

Chronic pain often is accompanied by other neuroplastic symptoms. For example, two or more of the following conditions commonly coincide: migraines, back pain, fibromyalgia, irritable bowel syndrome, chronic fatigue, bladder spasm, and many more. The good news is that if you have more than one symptom, they may share a single, treatable cause.

There's a better way to treat chronic pain

Most chronic pain is treated as though the body is still injured, through medications, injections, devices, and surgery. Some of that helps for a while, and there's no shame in leaning on it. But when the cause is neuroplastic, treatment aimed only at the body tends to fall short, because the pain is coming from the brain's learned signals.

Neuroplastic recovery therapies are the newer, evidence-based path, and they work where the pain starts. Pain Reprocessing Therapy (PRT) teaches the brain that the body is safe despite the pain, so the danger signal can switch off. Emotional Awareness and Expression Therapy (EAET) uncovers and eases the often unrecognized stress and emotion that keep the pathway on. Unlike mere coping strategies, these aim at the root cause, which is why the relief lasts.

Is chronic pain curable?

For neuroplastic pain relief, not just coping, is the goal. Many people become free of pain rather than only managing it. It is essential to begin after a clinician has ruled out other causes, but full relief is a realistic goal. In studies of people with years of chronic pain, most became pain-free or nearly pain-free after neuroplastic recovery therapy, and the results held for years of follow up. The speed of recovery varies from person to person, and setbacks along the way are expected, but the results over time become highly reassuring.

Did you know?

• In one study of people with an average of 10 years of chronic pain, two out of three were pain-free or nearly pain-free after one month of Pain Reprocessing Therapy. Their relief was sustained for at least five years. (Ashar et al., 2021 & 2025, JAMA Psychiatry.)
• In a study at Harvard, 64% became pain-free after a course of neuroplastic recovery therapy, versus 25% with mindfulness and 17% with usual care. (Donnino et al., 2021, PAIN Reports.)
• In chronic spine pain, neuroplastic pain is much more common than structural pain. (Schubiner et al., 2023, Journal of Pain.)
• 62% of people with ongoing symptoms have two or more conditions, and 29% have four or more. (2026 ATNS national survey.)

Hear from someone who recovered

What is CRPS, and what causes it?

Complex regional pain syndrome, formerly known as reflex sympathetic dystrophy or RSD, is severe, ongoing pain that usually affects an arm or leg, often after an injury, surgery, or even a minor event. The area can become swollen, hot or cold, discolored, and so sensitive that light touch is unbearable. It's one of the most painful conditions there is, and it deserves to be taken seriously and evaluated carefully by a physician.

CRPS is understood as a problem of the nervous system, not of ongoing damage at the injury site. After the original trigger, the brain and nerves can stay locked in a danger response, keeping pain and other changes switched on far longer and far stronger than the injury alone would explain. That amplification is neuroplastic. The pain is entirely real, and because the nervous system can be retrained, that part can ease.

Can stress and emotions affect CRPS?

They can. CRPS pain runs through the same danger system that stress and strong emotion set off, so life challenges can turn the pain up and calmer, safer periods can turn it down. Naming that link is not saying the pain is in your head, or that anyone brought it on themselves. It's one more sign that the nervous system is involved, which is what makes retraining it worth trying alongside medical care.

The symptoms

CRPS can include:

• Severe, burning or aching pain, often in an arm, leg, hand, or foot, out of proportion to the trigger.
• Extreme sensitivity, where light touch, temperature, or movement is painful.
• Changes in the skin color, temperature, swelling, or sweating in the affected area.
• Stiffness and reduced movement in the affected limb.
• Pain that spreads or intensifies over time.

CRPS should always be assessed by a physician. Where the nervous-system amplification is part of the picture, a short self-assessment can help you understand the neuroplastic component.

CRPS often comes with other symptoms

The same overactive nervous system can bring other symptoms alongside CRPS, from widespread pain to fatigue, dizziness, or symptoms like postural orthostatic tachycardia syndrome (POTS). If you have more than one, they may share a common, treatable cause.

There's a new approach to CRPS

CRPS is treated with medications, physical therapy, nerve blocks, and other medical techniques, and these matter, especially early. Alongside that care, treatment aimed at the nervous system can address the amplification that keeps the pain switched on.

Neuroplastic recovery therapies help calm an overactive danger response. Pain Reprocessing Therapy (PRT) and graded return to movement help the brain relearn that the limb is safe. Emotional Awareness and Expression Therapy (EAET) eases the stress and emotion that can keep the alarm on. These are meant to work with medical care, not replace it, and recovery should be pursued with a clinician.

Can CRPS be cured?

This is the question people search most, and the honest answer is hopeful but careful. CRPS can go into remission, and some people recover substantially, especially when the nervous-system component is treated alongside medical care. Recovery varies more than with milder conditions, and it should be pursued with a physician, but improvement is a realistic goal, not a false promise.

Did you know?

• About 1 in 3 adults experience neuroplastic symptoms of some kind. (ATNS national survey, 2025.)
• In other chronic pain conditions, treating the nervous-system component has brought relief where body-directed treatment alone did not. (Ashar et al., 2021 & 2025; Donnino et al, 2021; Yarns et al., 2024.)
• A study in the Netherlands estimated 26 new cases of CRPS annually per 100,000 population which would correspond to nearly 90,000 new patients per year in the U.S. (de Mos M et al., Pain. 2007)

Hear from someone who recovered

What causes chronic migraines and headaches?

Migraines and chronic headaches involve real, often disabling pain, sometimes with nausea, light and sound sensitivity, and visual changes. A doctor should rule out other causes first. But for many people, once that's done, the headaches continue with no structural explanation, and the standard treatments only go so far.

When headaches are frequent and persistent, the cause is often neuroplastic. The brain's danger system, wound up by stress, emotion or life challenges, can generate headache pain as a learned response and keep the pathway switched on. The pain is real. It's coming from an overactive nervous system, not from damage an MRI would show, and that can be retrained.

Can stress cause migraines and headaches?

Yes, and one everyday pattern shows it clearly: the weekend or "let-down" headache, the one that hits on your day off or the first day of vacation, after the stress lifts. That timing is a signature of a nervous system that has learned to produce headache pain. It doesn't mean the pain is in your head. It means it's neuroplastic, and treatable. [VERIFY: Dave — confirm the let-down-headache framing.]

The symptoms

Neuroplastic migraines and headaches can show up as:

• Frequent or chronic headaches that persist despite treatment.
• Migraine pain, often with nausea, or sensitivity to light and sound.
• "Let-down" or weekend headaches that arrive once stress eases.
• Headaches that flare with stress, emotion, or life challenges.
• Visual or sensory changes around the pain.

A telling sign it may be neuroplastic: headaches that track with stress, persist after a normal workup, and haven't responded to treatments aimed at the body. A short self-assessment can help you tell.

Headaches often come with other symptoms

Chronic headaches often do not travel alone. The same nervous-system pattern often brings spine pain, dizziness, fatigue, or other unexplained symptoms at the same time. If you have more than one, they may share a single, treatable cause.

There's a better way to treat migraines and headaches

Migraines and headaches are usually treated with medications, and these matter, especially for acute attacks and when a medical cause is found. When headaches are chronic and the workup is clear, treatment aimed at the nervous system can reach what medication alone cannot.

Neuroplastic recovery therapies retrain the brain's headache response. Pain Reprocessing Therapy (PRT) lowers the threat the brain attaches to the sensation. Emotional Awareness and Expression Therapy (EAET) uncovers the stress and emotion that keep the pattern on. These work alongside medical care, not in place of it.

Can chronic migraines be cured?

For neuroplastic headaches and migraines, meaningful, lasting relief is a realistic goal, and many people see their headaches fade rather than needing to keep coping with them. Because the pattern is learned, it can be unlearned. It's worth starting after a clinician has ruled out other causes.

Did you know?

• 35% of people with ongoing symptoms in the ATNS national survey reported headaches or migraines. (2025 ATNS national survey.)
• About 1 in 3 adults experience neuroplastic symptoms of some kind. (ATNS national survey, 2025.)
• Across chronic pain, most people improved substantially after neuroplastic recovery therapy. (Ashar et al., 2021 & 2025; Donnino et al., 2021. Yarns et al., 2024)

Hear from someone who recovered

What is pelvic, bladder, and genital pain, and what causes it?

This is pain in the lower abdomen, pelvic floor, bladder, or genital area that continues after infections and other medical causes have been ruled out. It includes ongoing pelvic pain and pressure, bladder pain with urgency and frequency that isn't explained by infection (sometimes called interstitial cystitis or painful bladder), and pain in the genital area.

The tests and exams usually come back normal, which is part of why people spend years without answers. That normal result points toward what's really happening. The pelvic floor and bladder are wired into the nervous system. Under sustained stress the brain can start reading ordinary signals from this area as an alarm and produce real pain, urgency, and tightness.

The pain is real. It isn't imagined, and it isn't a sign that something is wrong with your body. It comes from altered nerve pathways, and those pathways can change back to a healthy pattern.

Can stress or emotions cause pelvic, bladder, or genital pain?

Yes, and it doesn't mean the pain is in your head. The pelvic floor is one of the places the body holds tension, and the bladder is especially sensitive to the brain's danger response. Stress and strong emotion can switch that response on, and for some people it gets stuck, keeping the pain, urgency, or burning going long after anything is physically wrong.

The symptoms

Neuroplastic pelvic, bladder, and genital pain can show up as:

• Ongoing pelvic pain, aching, or pressure, often worse with sitting or stress.
• Bladder urgency, frequency, or discomfort that isn't explained by an infection (interstitial cystitis / painful bladder).
• Genital or vulvar pain or burning, including pain during sex, with a normal exam.
• Symptoms that flare with stress and ease during calmer stretches.
• Normal tests and exams, despite very real pain.

One set of clues points toward a neuroplastic cause: pain that flares with stress, moves or changes, and hasn't responded to treatments aimed at the body. A short self-assessment can help you tell.

Pelvic, bladder, and genital pain often come with other symptoms

This kind of pain often comes with digestive trouble like IBS, or back pain, or other unexplained symptoms. If you have several at once, they may share a single, treatable nervous-system pattern.

There's a better way to treat pelvic, bladder, and genital pain

Most people are offered medications, procedures, or pelvic-floor therapy aimed at the body, which are appropriate when there's an infection or a structural cause a doctor can find. But when the workup comes back clear and the pain continues, treatment aimed at the nervous system can reach what those approaches cannot. Neuroplastic recovery therapies work at the source, the learned signals in the brain. Both major types of these therapies are backed by randomized controlled trials and either can start once a clinician has ruled out infection and other causes:

• Pain Reprocessing Therapy (PRT) teaches the brain to read the sensations as safe, so the danger signal can switch off.
• Emotional Awareness and Expression Therapy (EAET) helps you recognize and release the stress and emotion the nervous system has been holding. This works alongside medical care, not in place of it.

Can pelvic and bladder pain go away?

Here's the honest, hopeful version. When this pain is neuroplastic, many people become free or nearly free of their symptoms rather than just managing them, because learned pathways can be unlearned. Recovery usually isn't a straight line, and you should start after a doctor has ruled out other conditions, but lasting relief is a realistic goal.

Did you know?

• About 1 in 3 adults, over 80 million Americans, experience neuroplastic symptoms. (ATNS national survey, 2025.)
• In the ATNS national survey, pelvis, abdomen, chest, and bladder symptoms were reported by about 14% of people with ongoing symptoms. (2026 ATNS national survey, figure 6.)
• Although neuroplastic therapy has not yet been formally studied for pelvic, bladder, and genital pain, in a study of people with years of chronic pain, two out of three were pain-free or nearly pain-free after Pain Reprocessing Therapy, with results holding at five years. (Ashar et al., 2021 & 2025, JAMA Psychiatry.)

Hear from someone who recovered

What are chest and breathing symptoms, and what causes them?

These are symptoms like chest tightness, pressure, or pain, and the feeling of not getting a full breath, that continue after a doctor has ruled out heart and lung causes. They can include chest-wall tenderness (sometimes called costochondritis), a need to sigh or yawn to feel you've taken a full breath, and an awareness of your own heartbeat.

When the heart and lungs are healthy, the cause of the pain is often neuroplastic. The chest and the breath are wired tightly into the brain's danger response, so under sustained stress the brain can generate real tightness and breathlessness as a kind of false alarm.

The sensation is completely real. It can be generated by an overprotective nervous system even when the heart and lungs are healthy.

Can stress or emotions cause chest and breathing symptoms?

Yes. The chest and breath are among the very first places the body's alarm shows up, which is why stress and strong emotion can bring tightness, breathlessness, or a racing heart even when nothing is wrong with the heart or lungs. Naming that link isn't saying it's in your head. It's the opening to treatment.

The symptoms

Neuroplastic chest and breathing symptoms can feel like:

• Chest tightness, pressure, or pain, sometimes tender to the touch (chest-wall pain), with a normal heart workup.
• A sense of not getting a full breath, or needing to sigh or yawn to feel satisfied.
• Breathlessness that comes with stress rather than with exertion.
• An awareness of your heartbeat or a racing heart when at rest.
• Symptoms that flare with stress and ease when things calm down.

A clue it may be neuroplastic: the symptoms flare with stress, come and go, and continue after your heart and lungs have been checked and found to be healthy. A short self-assessment can help you tell.

Chest and breathing symptoms often come with others

The same nervous-system pattern can also cause fatigue, digestive trouble, or widespread pain at the same time. If you have several symptoms at once, they may share a single, treatable cause.

There's a better way to treat chest and breathing symptoms

Once the heart and lungs are confirmed to be healthy, physicians might not offer a clear next step to find the cause. This leaves people worried and watching every breath. When the cause is neuroplastic, treatment aimed at the nervous system can reach what further testing can't. Neuroplastic recovery therapies lower the brain's threat response so the chest and breath can settle back into a sense of safety.

Pain Reprocessing Therapy (PRT) teaches the brain to read the sensations as safe, and Emotional Awareness and Expression Therapy (EAET) uncovers and eases the underlying stress the nervous system has been holding. This works alongside medical care, not in place of it.

Can chest and breathing symptoms go away?

Yes. When these symptoms come from a learned nervous-system pattern rather than damage, the brain can unlearn it, and many people recover. It is essential to work with a physician to confirm your heart and lungs are healthy first, but lasting relief is a realistic goal.

Did you know?

• About 1 in 3 adults experience neuroplastic symptoms. (ATNS national survey, 2025.)
• In the ATNS national survey, pelvis, abdomen, chest, and bladder symptoms were reported by about 14% of people with ongoing symptoms. (2026 ATNS national survey, figure 6.)
• Across chronic symptoms, most people improved substantially after neuroplastic recovery therapy. (Ashar et al., 2021 & 2025; Yarns et al., 2024.)

The Story

A short, written, story-arc narrative. [ Placeholder body — the arc of how the symptoms started, the long search, and how recovery came. ]

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Takeaways

• A short takeaway from the story
• A short takeaway from the story
• A short takeaway from the story

Resources Mentioned

• The condition(s)
• The therapies used (PRT, EAET, and others)
• Any books, podcasts, apps, or tools mentioned

Tell Us Your Story

Choose written or video, answer a short series of questions, then submit. ATNS reviews and publishes a selection.

What Neuroplastic Pain Means

Neuroplastic pain is generated by the brain and nervous system through learned nerve pathways. It is sometimes called nociplastic pain in the medical literature. It can show up when there is no injury or disease in the body. But it can also contribute to a physical condition, making symptoms more intense or longer-lasting than the condition alone would explain. "Neuro" means it comes from those nerve pathways. "Plastic" means they can change, so the pain can be reversed.

The pain is real. It isn't imagined, and it isn't a sign that something is wrong with your body. It comes from signals in the brain that can happen to anyone.

There are two kinds of pain.

All pain is made in the brain, but it comes in two kinds. Structural pain comes from injury or disease in the body, like a broken bone or a kidney stone, and you treat the body to heal it. Neuroplastic pain comes from a danger signal the brain has learned and keeps firing, with no tissue damage behind it.

One of the clearest examples is phantom limb pain, where a person feels real pain in a limb that is no longer there. There's nothing left to injure, yet the pain is unmistakable because the brain is creating it. In pain that has lasted a long time, neuroplastic is often the more common of the two.

Pain is an alarm signal.

Pain is the brain's alarm system, meant to protect you. Sometimes the alarm keeps going off long after any danger has passed. The pain is real, but it's coming from a nervous system stuck in a state of threat, not from damage in the body.

You already know the brain can create physical feelings on its own. A stressful day brings on a headache. Speaking in front of a crowd ties your stomach in knots. There's no injury, but the sensation is unmistakable. Neuroplastic pain works the same way.

Why the Brain Does This

The brain's danger system was built to protect you from physical threats. But stress, strong emotions, and hard experiences set off the very same alarm, and you can't step back from a worry the way you can step back from a fire. Over time the brain can learn to stay on alert, and the danger signal gets stuck in place, sometimes long after the body has healed. It can be set off by stress, trauma, or life challenges you may not have connected to your symptoms. It's a protective response, not a weakness or a character flaw.

Some of that stress goes back further than we tend to notice. One way to see it: picture a child growing up in the circumstances you did. If that brings up sadness or anger, your nervous system may have been dealing with more than you realized.

Could your pain be neuroplastic?

• It lasts longer than an injury should take to heal
• It moves around the body, or comes and goes
• It's set off by things like stress, weather, or certain people, situations or events
• Your scans and tests come back normal, or don't explain how much pain you're in
• It flares with stress or strong emotion
• It hasn't responded to treatments aimed at the body
• You have more than one symptom at once

If several of these sound familiar, your pain may be one of many neuroplastic symptoms, and a short self-assessment can help you tell.

What the brain learns, it can unlearn.

Just as the brain learned to talk, walk, and worry, it learned these pain pathways through practice, until they ran on their own. What the brain learns, it can unlearn.

The tools aren't medicine, supplements, or procedures. They work by teaching the brain that it's safe, so the danger signal can taper and the pathway can quiet down. You learn to respond to the sensations differently, reading them as a false alarm rather than a sign of damage. With practice, the brain rewires and the pain eases.

Recovery, not just coping, is the usual outcome with neuroplastic recovery therapies.

Common Questions

Go Deeper

Explore books, apps, and podcasts on our self-treatment resources page.

For Clinicians

Neuroplastic recovery therapies are evidence-based and designed to complement standard care, not replace it. Diagnosis begins as it should, with a workup to rule out structural or organic disease. When symptoms persist or don't respond as expected, multiple studies have shown that treating the neuroplastic component brings far better relief than older approaches.

About ATNS

The Association for the Treatment of Neuroplastic Symptoms (ATNS) is a 501(c)(3) nonprofit that educates the public, patients, and practitioners about the diagnosis and treatment of neuroplastic pain and illness. It is founded and led by volunteer clinicians.

ATNS White Papers

• Why people reject a neuroplastic diagnosis
• Based on the 2026 national survey (planned — link when published)

How Neuroplastic Recovery Works

Neuroplastic recovery therapies retrain the specific brain pathways that produce physical symptoms. The nervous system can hold on to stress and strain that even healthy, capable people never notice, and it can keep generating symptoms long after the original cause has passed. The work retrains that response.

It isn't about fixing something that's wrong with you. People who develop these symptoms are at least as mentally strong as anyone else, but usually are carrying more stress than they recognize.

With a physician, therapist, coach, app, course, or book, most patients move through some version of these steps:

• Understanding the diagnosis — recognizing that the cause is a learned brain pathway rather than damage in the body. For many patients, a clear and accurate explanation, often the first they've had, is the beginning of relief.
• Reducing the threat response — as you learn the symptoms aren't dangerous, the brain's alarm begins to quiet, and you can gradually return to the activities you've avoided.
• Recognizing the nervous system's role — symptoms often track with stress and emotion the nervous system is holding, even for people who are fairly self-aware. Learning to notice and ease it is part of switching the symptoms off.
• Addressing the patterns that keep the alarm on — easing the pressure, self-criticism, and tendency to put everyone else first that keep the nervous system on alert, and building self-compassion in their place.

Other Approaches, and Where They Fall Short

You might have already tried other psychological or invasive medical treatments such as CBT, mindfulness, nerve blocks, or even surgery. A few provide limited relief for a while, but they don't address the learned signals driving neuroplastic symptoms. Here's what the evidence says about each, and why ATNS emphasizes PRT and EAET for lasting recovery.

Common Questions

How It Works

PRT starts with understanding. The pain is real, but it's coming from the brain, not from damage in the body.

From there, you learn to take the threat out of the sensation. A core practice is somatic tracking. You turn toward the sensation and observe it with curiosity and calm, instead of bracing against it. Little by little, that teaches the brain there's nothing to protect against.

Then you return to the movements, foods, and situations you've been avoiding, reminding your body it's safe each time. Over time, the brain stops sounding the alarm.

Find a Practitioner

Explore our clinician directory to find practitioners who treat neuroplastic symptoms. Many practice Pain Reprocessing Therapy and Emotional Awareness and Expression Therapy, often alongside other approaches. Every provider works a little differently, so it's worth speaking with them directly about their approach to find the right fit.

How It Works

EAET helps you connect the dots between your symptoms and the experiences behind them. You identify the emotions that have been buried or felt unsafe to feel, often anger, guilt, or sadness, and the situations, stresses, or traumas that created them. Then you learn to feel and express those emotions safely, in the present, so the nervous system no longer has to hold them in the body. Recognizing the link between a past situation and a present symptom is often the turning point.

The Evidence

In randomized trials, EAET outperformed standard psychological care and reduced chronic musculoskeletal pain (Yarns B, et al., 2024, JAMA Netw Open). It grows out of decades of ISTDP research (Abbass) and is named as a treatment option in the U.S. HHS Pain Management Best Practices report.

Find a Practitioner

Explore our clinician directory to find practitioners who treat neuroplastic symptoms. Many practice Pain Reprocessing Therapy and Emotional Awareness and Expression Therapy, often alongside other approaches. Every provider works a little differently, so it's worth speaking with them directly about their approach to find the right fit.

A Free Self-Treatment Course

A self-paced introduction to understanding and treating neuroplastic symptoms, free to start. Members unlock the full course and ongoing support.

Membership may be a good fit if…

• You're living with neuroplastic symptoms and want support and tools as you recover
• You're supporting someone who is dealing with neuroplastic symptoms
• You're a practitioner who wants to connect with peers and stay current
• You want to support the ATNS mission to bring evidence-based neuroplastic care to everyone who needs it

Common Questions

About ATNS

ATNS is a 501(c)(3) nonprofit, founded and led by volunteer clinicians, researchers, and patient advocates. Our Board Members have been featured in outlets like PBS, The Washington Post, Psychology Today, and U.S. News.

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