But my symptoms started after something actually happened to me.
I hear some version of this all the time. Maybe your back pain started after you lifted something heavy. Your symptoms appeared after COVID, the flu, or another infection. You had surgery, a car accident, a difficult pregnancy, or a stomach bug. Maybe you can point to the exact day everything changed. So when someone introduces the possibility that your symptoms could now have a neuroplastic component, it can feel like the two stories don’t fit together. If there was a real injury or illness at the beginning, doesn’t that prove there’s still something physically wrong?
Not necessarily. And I think this distinction matters because my own symptom history didn’t begin with me waking up one morning inexplicably in pain throughout my entire body. It started with wrist pain. There was a beginning, and for years I approached what happened afterward from the completely reasonable assumption that if my body hurt, something in my body must still be wrong. As my symptoms grew and changed, I kept looking for the physical explanation that would finally connect all of the dots.
One of the things I eventually had to understand was that the thing that starts a symptom and the thing that keeps it going aren’t always the same thing. Sometimes there was an injury. Sometimes you were sick. Sometimes pain, fatigue, dizziness, nausea, or another symptom was completely appropriate at the beginning. Exploring neuroplasticity doesn’t require rewriting that history.
The question isn’t whether the original problem was real. The question is whether it still explains what’s happening now.
Your brain is supposed to learn from things that hurt
Let’s say you hurt your back lifting a heavy box. In the beginning, pain is doing exactly what it’s supposed to do. It gets your attention, encourages you to protect the area, and gives your body some time to recover. You may move differently for a while because bending genuinely hurts. Meanwhile, your brain is paying attention. It learns that bending hurts. It learns that lifting might be risky. Maybe sitting for too long leads to a miserable afternoon, so it remembers that too. None of this is your nervous system malfunctioning. It’s actually a pretty reasonable response to getting hurt.
The interesting question is what happens later. Your body can recover while your nervous system still remembers what happened when you bent, lifted, sat, ate, exercised, or did whatever became associated with the original problem. You bend over again and, before you’ve had much time to think about it, your brain already has a prediction about what comes next: This hurts. Or perhaps even, This is going to hurt.
That’s possible because pain isn’t simply a readout of tissue damage. The brain interprets information coming from the body in the context of previous experiences, expectations, attention, and perceived danger. Something that genuinely hurt while you were injured can therefore become something your nervous system has learned to protect you from even after the original circumstances have changed.
I think about this less as the brain getting something terribly wrong and more as it being a little slow to update the file. Bending = danger was useful information for a while. The problem is when nobody sends the follow-up memo saying, Okay everyone, we’re good here. Stand down.
Illness can create a similar learning history. Imagine getting a terrible stomach virus. For several days, nausea is an entirely appropriate response because you are actually sick. But what if the infection resolves and months later you’re still waking up nauseated, becoming increasingly sensitive around food, or noticing that symptoms reliably appear in situations you’ve come to associate with feeling sick? That doesn’t prove the symptoms are neuroplastic. Persistent symptoms after illness can have ongoing medical causes and deserve appropriate evaluation. But the fact that an illness started the story doesn’t necessarily mean that illness is still responsible for every chapter that came afterward.
That’s the part I want to leave room for. The original physical event and a nervous system that learned from that event can both be real.
What matters to me is what the symptoms are doing now
This is where I think people understandably get stuck on the history. But they found a disc bulge. I really did hurt my shoulder. I really did have COVID. My stomach problems really did begin after an infection. Yes. I don’t need to argue with any of that in order to become curious about what is happening today.
If there’s an MRI finding, for example, I’m not interested in convincing someone that it means nothing. That’s outside my role anyway, and sometimes structural findings absolutely matter. I’m much more interested in whether the explanation you’ve been given accounts for the whole symptom pattern. Does the symptom behave consistently? Has it spread beyond the original area? Does the supposedly problematic activity sometimes cause symptoms and sometimes not? Are there things you were told you shouldn’t be able to do that you occasionally do just fine? Do symptoms change dramatically with context, attention, stress, distraction, or expectation?
Those details matter because bodies are messy. Someone can have an old injury and a sensitized nervous system. There can be structural changes and learned fear around movement. An illness can have been completely real and the nervous system can continue producing or amplifying symptoms after the original threat has changed. We don’t have to cram every person into either “structural” or “neuroplastic” and then defend our side.
Sometimes the original danger is gone, but the protection remains
Imagine that every time you raise your arm after a shoulder injury, you get a sharp pain. Naturally, you become careful with your arm. Maybe you stop reaching overhead or hesitate before putting on a shirt. Eventually the shoulder heals enough that reaching is safe again, but you don’t experience reaching as neutral. You experience it as the thing that hurts.
Then one day you reach toward a shelf and feel that familiar sensation. There it is. You stop. From your brain’s perspective, this is a pretty convincing sequence of events. It expected danger, you felt pain, and you protected the shoulder. Nothing about that experience gives the nervous system much reason to reconsider its prediction.
This is where I think the phrase “it’s healed” can sometimes be less reassuring than people expect. You can intellectually understand that an injury should have healed and still have a nervous system that responds to the movement as if it hasn’t. I see the same thing when someone has been medically cleared to do something but their entire body is screaming ABSOLUTELY NOT. Information matters, but sometimes the brain needs experiences that match the information.
That doesn’t mean I want someone marching into a gym and throwing dumbbells over their head while yelling that their shoulder is safe. Please don’t. It means that, when appropriate, we can begin looking at what the nervous system expects and whether there are ways to gently give it different information. The specifics of that look very different from one person to another, which is part of why I don’t think a generic list of “neuroplastic exercises” is particularly useful here.
You don’t have to choose between “it was real” and “it’s neuroplastic”
I think this is the part I most want someone with a clear injury or illness onset to take away from this article. Exploring neuroplasticity does not require you to decide that nothing happened to you. It doesn’t require pretending an injury wasn’t painful, an illness wasn’t serious, or a medical finding doesn’t exist.
Something may have happened. Your body responded. Your brain learned from it.
What I want to know is what happened after that.
When did the symptom change? What does it do now that it didn’t do in the beginning? What have you become afraid to do because of it? Where are the inconsistencies? What happens on your best days? Does the explanation you were originally given still account for everything you’re experiencing, or have you accumulated details over the years that don’t quite fit? Those are the questions I find much more interesting than simply asking whether your symptoms began with something physical. Of course they may have. That only tells us how the story started.
And sometimes, when I sit down with someone and we lay the whole story out, the pattern starts making more sense. Maybe the original injury still matters. Maybe there’s a medical piece that needs more attention. Maybe there are strong clues that the nervous system has become part of what is keeping the symptoms going. Often the most useful answer isn’t an immediate either/or.
It’s: What explains what’s happening in your body now?
If you’ve been hesitant to consider neuroplastic symptoms because you know exactly what started yours, you don’t need to talk yourself out of your own history. You can start by getting curious about everything that has happened since.
Sometimes the injury or illness explains how the symptoms started.
The nervous system may help explain why they didn’t stop.
If you’re wondering whether that could be part of your particular symptom history, you can take my Neuroplastic Symptoms Self-Assessment or read How Do I Know If My Symptoms Are Neuroplastic? and Does Structural Damage Rule Out Neuroplastic Pain or PRT?
And if your story feels much too complicated for a checklist—which, frankly, many people’s do—I offer free 15-minute connect calls. You don’t need to come in already convinced that your symptoms are neuroplastic. Tell me what happened, what your symptoms have done since then, and where things stopped making sense. That’s the part I want to look at with you.
About the Author
Amberleigh Maida, ICF-ACC, is an Advanced Pain Reprocessing Practitioner and life coach with training in Emotional Awareness and Expression Therapy (EAET). She also holds a master’s degree in creative writing with a focus on nonfiction. Drawing on both professional training and personal experience with chronic pain, she writes about neuroplastic symptoms, the brain-body connection, and approaches to chronic pain and other persistent symptoms.
