When Pain Persists: A Somatic Approach to Chronic Pain

Understanding why pain continues—and what your nervous system has to do with it

The Mystery of Persistent Pain

You've been to specialists. You've tried medications, physical therapy, maybe even surgery. The imaging doesn't fully explain what you're feeling. Or perhaps it did once, but the original injury has healed—yet the pain remains.

If this sounds familiar, you're not alone. And more importantly, there's nothing wrong

with you.

What you're experiencing may be your nervous system's way of protecting you—a protection that's become overactive and no longer serves you.

When the Alarm System Gets Stuck

Think of pain as your body's alarm system. When you touch a hot stove, pain signals travel to your brain, and you pull your hand away. This system is designed to protect you.

But here's what pain science now understands: the alarm system itself can become sensitized. After months or years of pain, your nervous system can learn to produce pain signals even when there's no ongoing tissue damage. It's not "all in your head"—it's in your nervous system, which is very real and very physical.

This is called neuroplastic pain or central sensitization, and it explains why pain can spread to new areas, why things that shouldn't hurt (like light touch or movement) become painful, why stress and emotions intensify physical pain, and why traditional pain treatments stop working.

Why the Mind-Body Split Doesn't Work

For decades, we've divided pain into two categories: "real" physical pain from tissue damage, and "psychological" pain that's supposedly in your head. This split has left countless people feeling dismissed, doubted, or told their pain isn't real.

The truth is more complex—and more hopeful. Your pain IS real. And it's also deeply

connected to your nervous system, your life experiences, your stress levels, and yes, unprocessed emotions and trauma. This isn't weakness. It's biology.

What Your Body Might Be Trying to Tell You

In my 30 years of working with chronic pain, I've observed patterns. Pain often appears or intensifies when we've learned it's not safe to feel or express emotions, when we're in situations that feel threatening but we can't escape, when we've experienced trauma that was never fully processed, when we're living in ways that don't align with our deeper needs, or when we're carrying responsibilities or relationships that drain us.

The body doesn't lie. When we can't say "no," can't leave, can't express anger or grief—the body may speak for us through pain.

This doesn't mean you "caused" your pain or can just think it away. It means your pain may be responding to real threats in your environment and nervous system.

The Somatic Approach: Working WITH Your Nervous System

Somatic therapy for pain works differently from traditional approaches. Instead of fighting pain or trying to push through it, we take a different path.

First, we calm the alarm system. Before anything else, we help your nervous system feel safer. This might include specific breathing patterns matched to YOUR nervous system (not generic techniques), gentle movement that rebuilds trust in your body, and polyvagal-informed practices that regulate your stress response.

Second, we listen to what pain is protecting you from. We explore gently, at your pace: What was happening in your life when pain began or worsened? What emotions might be difficult or unsafe to feel? What might need to change for your nervous system to relax?

Third, we rewire the pain pathways. Using approaches like Pain Reprocessing Therapy,

we help your brain learn that movement is safe, that sensations don't always mean danger, and that your body is capable of healing.

Finally, we address the whole context. We look at sleep, stress, and nervous system health. We explore relationships and boundaries. We attend to unprocessed trauma or grief. We examine life circumstances that may need to shift.

What This Looks Like in Practice

Sarah, 45, had lived with debilitating back pain for 7 years. She'd had surgery, done months of physical therapy, and tried every pain medication. Nothing helped.

In our work together, we didn't focus directly on the pain at first. We worked on calming her chronically activated nervous system, processing the grief and rage she'd never felt safe expressing, exploring what her body might be saying "no" to, and introducing gentle movement that felt safe and curious rather than punishing.

Over several months, Sarah's pain began to shift. Not because she became "stronger" or "fixed" anything—but because her nervous system no longer needed to shout so loudly. She still has occasional pain, but it no longer controls her life. More importantly, she learned to listen to what her body was trying to communicate.

Signs Somatic Therapy Might Help Your Pain

Consider this approach if your pain persists despite medical treatment, if imaging doesn't fully explain your symptoms, if pain started or worsened during stressful life periods, if you have a history of trauma or chronic stress, if pain spreads or changes locations, if traditional pain management hasn't worked, if you notice emotional stress affects your pain levels, or if you feel disconnected from your body.

The Journey Forward

Healing from chronic pain isn't usually quick or linear. But when we understand pain as a messenger rather than an enemy, when we work WITH the nervous system rather

than against it, real change becomes possible.

You've likely tried so hard for so long. You're not broken. Your body isn't betraying you. Your nervous system is doing exactly what it learned to do to protect you. Now it's time to teach it something new.

Next Steps

If this resonates with you, I offer complimentary 15-minute consultations to discuss whether somatic therapy might be right for your situation. This work requires patience, curiosity, and compassion—for yourself and your body's journey.

Your pain has a story. Let's listen to it together.

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Samantha is a member of the International Association of Yoga Therapists, a Noom Certified Health Coach, and the founder of Davidson Yoga Therapy and Health Coaching.

She has held complimentary healthcare positions at The Blanchard Institute, Atrium

Hospital, Levine Cancer Institute, Sanger Heart Clinic, and Davidson College. She has presented for Fortune 500 companies and major Universities, both public and professional audiences, on this thing called yoga therapy and what it can do when it is unpeeled, revealed, and adapted to meet the needs and the abilities of the person doing it. 

She leverages her three decades of yoga therapy, and health coaching experience with the following therapeutic models:

• Breathing Technology

• Mindfulness-Based Stress Reduction

• Jungian Psychology

• Jungian Dream Interpretation

• Somatic Cognition

• Internal Family Systems

• Interfaith Perspectives

• Spiritual Technologies

• Trauma Healing

• Polyvagal Somatics

• Ayurvedic Lifestyle Coaching

• Compassionate Inquiry

• Pain Reprocessing Therapy

• The Neurosequential Model

All this is to say, there are many doorways to use on the path to healing and self-discovery, and Samantha’s breadth of experience allows for vast creativity on which approach is right for you!