Chronic pain
Chronic pain is pain that persists for longer than three months or recurs regularly.
Sometimes pain continues after an initial injury has healed. For others, an underlying condition or damage continues to cause pain.
In chronic pain, the brain and nervous system play a major role in processing, amplifying, and inhibiting pain signals.
Changes in these processes can contribute to persistent pain complaints.
The pain is real, even when medical examinations do not show clear tissue damage that fully explains the symptoms.
At BRAI3N, we investigate how brain networks are involved in chronic pain and whether neuromodulation can be an additional treatment option for certain patients.
In doing so, we take into account the cause of the pain, previous treatments, and the available scientific evidence.
What is it?
Why does pain sometimes persist?
Pain is an important protective mechanism. When you are injured, the nervous system warns you of potential damage.
Normally, pain decreases as the body heals.
With chronic pain, this process does not always go as expected. Pain signals can persist, be processed more intensely, or become more difficult to suppress.
Sometimes there is still a physical cause, such as inflammation, a joint condition, or a damaged nerve. In other cases, changes in the nervous system's pain processing play a larger role.
Chronic pain therefore does not necessarily mean that new tissue damage is constantly occurring.
The way the brain and spinal cord process pain signals can also contribute to the persistence of symptoms.
What happens in the brain during chronic pain?
Our brains have various collaborative networks that determine how pain is perceived and regulated.
Scientific research distinguishes three important processes:
1. Perceiving pain
The sensory pain system processes information about the location, intensity, and nature of pain. This allows you to feel, for example, where something hurts and how strong the pain is.
2. The unpleasant experience of pain
Other brain regions determine how much attention a pain signal receives and how threatening or burdensome it is perceived to be. The insula and the anterior cingulate cortex, among others, play a role in this.
This helps explain why chronic pain can be so exhausting and why pain can constantly demand your attention.
3. Regulating and suppressing pain
Our brains also possess a natural pain-modulating system. This network can inhibit pain signals, but under certain circumstances, it can also amplify them.
In some forms of chronic pain, the interaction between these systems functions differently, which can cause pain signals to be experienced more intensely or for longer periods.
Chronic pain as a disruption of brain networks
Our research shows that in people with chronic neuropathic pain, changes can occur in the balance between brain regions that process pain and regions involved in pain suppression.
Communication between these brain regions may also be altered.
Other studies show that chronic pain is associated with broader brain networks involved in attention, emotions, body perception, and cognitive control.
These insights help explain why chronic pain is often accompanied by fatigue, sleep problems, difficulty concentrating, and increased sensitivity to stimuli.
Chronic pain is therefore more than just a pain signal from the body.
It is a complex experience in which the body, nervous system, and brain are constantly working together.
This offers important starting points for treatments that are not focused solely on the original site of pain, but also on how pain is processed in the nervous system.
How to treat
Neuromodulation: targeting pain networks
When chronic pain persists despite previous treatments, it may be useful to also examine the involved pain networks in the brain.
Neuromodulation is a treatment approach that uses electrical or magnetic stimulation to influence the activity of nerves and brain networks.
In the case of chronic pain, the goal can be to modulate brain networks involved in pain processing and pain regulation. In this way, we attempt to influence the processing of pain signals and support natural pain control.
At BRAI3N, scientific research into these mechanisms is an important part of our approach.
What can neuromodulation mean for chronic pain?
Various studies have shown that certain forms of neuromodulation can reduce pain in selected patients.
Repetitive transcranial magnetic stimulation (rTMS) of the motor cortex, in particular, has been studied for conditions including neuropathic pain and fibromyalgia.
Transcranial electrical stimulation, including tDCS, is also being investigated as a potential treatment for chronic pain.
The results show that these techniques can influence pain-processing brain networks. However, the degree and duration of pain relief vary depending on the technique, the pain mechanism, and the patient.
Neuromodulation thus offers an additional treatment option for certain forms of chronic pain, especially when previous treatments have not provided sufficient relief.
A treatment tailored to your personal situation
Not every form of chronic pain has the same cause. That is why at BRAI3N, we first carefully examine which factors may be contributing to your symptoms.
Our treatment process can consist of four phases.
1. Assessment
We begin with an evaluation of your pain symptoms, medical history, and previous treatments. We also focus on your sleep, fatigue, concentration, and daily functioning.
When indicated, a qEEG measurement and analysis can provide additional information about electrical brain activity. However, a qEEG cannot independently identify the cause of chronic pain or predict which treatment will work best.
2. Targeted treatment
Based on the clinical assessment, we will discuss which treatments are most appropriate and whether neuromodulation could play a meaningful supplementary role.
Depending on your pain mechanism and medical situation, we can determine whether targeted magnetic or electrical stimulation is an option.
In doing so, we take into account the available scientific evidence, previous treatments, and potential risks or contraindications.
3. Stabilization
During the treatment process, we monitor how your symptoms evolve. We look not only at pain intensity but also at your resilience, sleep, daily activities, and quality of life.
The treatment plan will be adjusted as necessary.
4. Maintenance
When improvement occurs, we look at how to best maintain it. Adapted exercise, rehabilitation, pain education, psychological support, or further medical follow-up can be important in this regard.
Not every patient goes through the same phases or requires the same treatment.
Contact us for a no-obligation consultation or to schedule an appointment
Scientific Background
BRAI3N’s neuroscientific approach is built on research into pain processing, brain networks, and neuromodulation. Researchers affiliated with BRAI3N, or who have contributed to its scientific development, have published their findings in international scientific journals.
Below is a selection of our publications that provide insight into the mechanisms of chronic pain and potential treatment strategies.
The Locus Coeruleus in Chronic Pain
Castejón España J, Yasoda-Mohan A, Vanneste S. The Locus Coeruleus in Chronic Pain.International Journal of Molecular Sciences. 2024;25(16):8636.
Read the article in the journal
De Ridder D, Vanneste S, Plazier M, Vancamp T. Mimicking the brain: evaluation of St Jude Medical's Prodigy Chronic Pain System with Burst Technology.Expert Review of Medical Devices. 2015;12(2):143–150.
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Chronic Pain – A Maladaptive Compensation to Unbalanced Hierarchical Predictive Processing
Castejón J, Chen F, Yasoda-Mohan A, Ó Sé C, Vanneste S. Chronic pain – A maladaptive compensation to unbalanced hierarchical predictive processing.NeuroImage. 2024;297:120711.
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Chronic Pain as a Brain Imbalance Between Pain Input and Pain Suppression
Vanneste S, De Ridder D. Chronic pain as a brain imbalance between pain input and pain suppression.Brain Communications. 2021;3(1).
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Yearwood T, De Ridder D, Yoo HB, Falowski S, Venkatesan L, To WT, Vanneste S. Comparison of neural activity in chronic pain patients during tonic and burst spinal cord stimulation using fluorodeoxyglucose positron emission tomography.Neuromodulation. 2020;23(1):56–63.
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Disentangling Sex-Specific Mechanisms in Neuropathic and Nociplastic Chronic Pain: A Review
Vanneste S, Castejón-España J, Arulchelvan E, De Ridder D. Disentangling sex-specific mechanisms in neuropathic and nociplastic chronic pain: a review.Frontiers in Neurology. 2026;16:1730291.
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ENIGMA-Chronic Pain: A Worldwide Initiative to Identify Brain Correlates of Chronic Pain
Quidé Y, Jahanshad N, Andoh J, et al. ENIGMA-Chronic Pain: a worldwide initiative to identify brain correlates of chronic pain.PAIN. 2024;165(12):2662–2666.
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Long Exhalations as Complementary Treatment for Chronic Pain: A Pilot Study
Castejón-España J, Vanneste S. Long Exhalations as Complementary Treatment for Chronic Pain: A Pilot Study.Journal of Clinical Medicine. 2025;14(22):7975.
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Broecker F, Vanneste S. Non-Invasive Brain Stimulation in Chronic Pain: Current Evidence, Network Perspectives and Paths to Personalization.Sensory Neuroscience. 2026;2(1).
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Authored by Prof. Dr. Sven Vanneste, Prof. Dr. Dirk De Ridder and Jan Ost - 10/09/2026
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