6 Reasons Why You Still Have Pain Over 3 Months Later

If you’ve been experiencing pain for more than three months, you’re probably frustrated and wondering why it hasn’t improved. The lingering pain can feel like a mystery, especially if you’ve tried treatments or even been told there’s no clear injury. Here’s the surprising truth: pain that sticks around is often less about physical damage and more about how your body and mind are responding to the original issue.

When pain is persistent or recurring for more than 3-6 months, it is referred to as chronic. This is because the pain process is different to that of a new injury (if that's how it started), and by this time, any original injury is highly likely to have healed - even though it may not feel like it. Let’s break down the key reasons why pain persists.

1. Chronic Stress Keeps You in "Fight-or-Flight" Mode

When your body is stressed, it triggers the “fight-or-flight” response. This mechanism is designed to protect you in dangerous situations, but when it's constantly switched on (as with chronic stress), it keeps your body in high alert mode. Studies show that prolonged activation of the nervous system, specifically the hypothalamic-pituitary-adrenal (HPA) axis, can worsen pain, even if the original injury has healed (Martínez-Lavín, 2007; McBeth & Mulvey, 2012). In short, chronic stress makes your body overly sensitive, and pain becomes more intense.

2. Fear of Pain Fuels the Pain Itself

When we’re afraid of pain, we tend to avoid activities that might trigger it. This avoidance, while understandable, can actually lead to worse pain in the long run. The fear-avoidance model shows that when you fear certain movements or activities, you increase your body’s pain sensitivity and delay healing (Vlaeyen & Linton, 2000). The more you avoid, the more your body "expects" pain, and it keeps your nervous system on edge, amplifying the pain signals.

3. Compensation Patterns are Making Things Worse

When you're in pain, you often change the way you move, maybe without even realizing it. For example, you might limp or shift your posture to avoid pain. While these compensation patterns may offer short-term relief, they can create long-term problems. By overusing certain muscles or joints to compensate, you’re placing strain on other areas of your body. Over time, these new ways of moving can become ingrained, causing secondary pain or even worsening the original issue. Your body gets stuck in inefficient movement patterns that keep the pain cycle going.

4. Inflammation, Not Damage, Might Be Driving Your Pain

It’s easy to assume that ongoing pain means ongoing damage, but research shows that pain can persist long after tissue damage has healed. One of the main culprits is inflammation. Inflammatory processes can continue to send pain signals to your brain even when there's no physical damage left. Inflammation can activate the nervous system, making your body more sensitive to pain. This type of pain, often called “inflammatory pain,” can last for months or even years, driven by the immune system rather than structural damage (Grace et al., 2014; Scholz & Woolf, 2007). So, if your body is stuck in a cycle of inflammation, it’s no wonder the pain lingers.

It's worth noting that this inflammation may also appear from non-injury sources, such as illness, infection, 'wear & tear', a diet high in sugar and low in fresh fruit, vegetables, and Omega-3 fats.. And especially from a heightened nervous system.

5. Trauma and Emotional Stress Can Resurface as Physical Pain

Emotional trauma or ongoing psychological stress can have a profound effect on your body, and for some, it shows up as physical pain. For instance, fibromyalgia and other chronic pain conditions are often linked to unresolved trauma or post-traumatic stress disorder (PTSD) (Amris & Jespersen, 2010). Your body may “hold onto” emotional stress, converting it into physical symptoms as a way of trying to protect you. While this can be a protective response, it also means your body is working against itself, keeping the pain alive.

6. Your Nervous System Might Be Misfiring

When pain persists for months, the nervous system itself can become “stuck” in a pain cycle. Even if there’s no longer a physical threat, your nervous system can continue to amplify pain signals. This misfiring is your brain’s way of being overly cautious, but it can turn temporary pain into a chronic problem (McEwen & Kalia, 2010). Essentially, your body becomes hypersensitive, interpreting normal sensations as painful ones.

Moving Beyond Pain: It’s Not Just About Damage

If you’ve been dealing with pain for over three months, it’s essential to realise that it’s not just about physical damage anymore. Your body’s nervous system, stress levels, compensation patterns, and even unresolved emotional trauma are ALL playing a part. The good news is that by addressing these factors – calming the nervous system, reducing inflammation, correcting compensation patterns, and managing stress – you can finally start to recover.

The key to overcoming chronic pain lies in understanding that it’s more complex than just an injury. Your pain may have outlasted its physical cause, but with the right approach, you can break the cycle and begin to heal.

Sarah Court BSc BTAA

Pain & Stress Recovery Specialist