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Why won’t my pain go away? Understanding chronic musculoskeletal pain
Nicola Tik
February 10, 2026
When pain lasts longer than you expected, it can be confusing and frustrating. You may have been told your tissues have healed, scans may look normal, and yet the pain is still there. It is very common to wonder what this means and whether something is being missed.
The key idea is this. Ongoing pain does not always mean ongoing injury. In many cases, chronic musculoskeletal pain is driven more by a sensitive nervous system than by continued damage in your body. Understanding this shift can change how you think about your pain and, importantly, how you respond to it.
In the early stages of an injury, pain serves a clear protective purpose. It encourages you to rest, protect the area, and avoid further harm. But once tissues have healed, pain does not automatically switch off.
Sometimes your nervous system remains on high alert, continuing to produce pain even when the original injury has resolved. This does not mean your pain is imaginary or “in your head”. It means your body’s alarm system has become more sensitive than it needs to be.
You can think of it a bit like a smoke alarm that keeps going off even after the fire has been put out. The alarm is real, but the level of threat has changed.
When pain persists, your nervous system can gradually become better at detecting danger. This process, often called sensitisation, makes you more likely to feel pain in response to everyday movements, stress, or fatigue.
Several factors can influence how sensitive your system becomes. Your thoughts and beliefs about pain matter. If you feel worried, fearful, or helpless, your brain is more likely to interpret your body as under threat, which can increase pain.
Sleep plays a powerful role as well. Poor or disrupted sleep makes your nervous system more reactive and can lower your pain threshold. Similarly, high stress levels can amplify pain, even when your body itself has not changed.
Your activity patterns also shape your pain experience. If you have been avoiding movement because of fear, your body may become stiffer, weaker, and more sensitive, which can make pain feel worse rather than better.
When pain first appears, it is natural to protect yourself. But if protection turns into long-term avoidance, it can keep pain going rather than helping it settle.
Avoiding movement reduces your confidence in your body and can make your nervous system even more alert. Over time, this can create a cycle where pain leads to avoidance, avoidance leads to sensitivity, and sensitivity leads to more pain.
Breaking this cycle does not mean forcing yourself to push through severe pain. It means gradually and gently reintroducing movement in a way that feels safe and manageable, so your body can relearn that it is not under constant threat.
One of the most important things to understand about chronic pain is that it usually has clear, explainable mechanisms, even if the experience feels unpredictable.
Your pain is shaped by a combination of your body, your brain, your habits, your sleep, and your stress levels. When these pieces come together in the wrong way, pain can persist. When they come together in a healthier way, pain can settle.
This also means chronic pain is not necessarily permanent. Because your nervous system can become more sensitive, it can also become calmer again. With the right balance of movement, rest, and support, your body can gradually return to a less reactive state.
Chronic musculoskeletal pain is often:
Understanding chronic pain does not make it disappear overnight, but it can reduce fear and give you back a sense of control. When you see pain as a modifiable system rather than a fixed problem, it becomes easier to make choices that support recovery.