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Dr Rangan ChatterjeeDr Rangan Chatterjee

The Real Reason Pain, Fatigue & Anxiety Won't Go Away | Howard Schubiner

The Thrive Tour: Transform Your Health and Happiness, a live show: Book Your Tickets https://drchatterjee.com/live This episode is brought to you by: AG1: Get FREE AG1 Flavour Sampler, AGZ Sampler, Vitamin D3+K2 and Welcome Kit with your first AG1 subscription (worth $87, US only) https://bit.ly/43FwxQl Imagine being told for 25 years that your pain is incurable – then making a full recovery within six weeks. That’s exactly what happened to one of the case studies in this episode and his story is far from exceptional. Could it be that much of the chronic pain we accept in life isn’t evidence our body is broken, but a sign our brain is trying to protect us? My guest this week is Dr Howard Schubiner, one of the world’s leading experts in chronic pain and the mind-body interaction. He’s spent more than 20 years working wonders with people who’d been told their pain was untreatable. He’s published over 100 scientific papers, runs one of the most respected programmes of its kind in the US, and his new book, Unlearn Your Pain, is set to transform how we think about suffering. To kick off this game-changing conversation, Howard debunks some common beliefs around pain, including the assumption that an MRI scan will accurately diagnose back issues. We talk about why bulging discs, degeneration and other scary-sounding findings show up just as often in people who aren’t in pain. And why the language used in scan reports can sometimes do real harm. To explain this, Howard talks us through the difference between structural and neuroplastic pain. The key learning here? All pain is created by the brain, through something called predictive processing. In structural pain, there’s clear tissue damage so your brain creates pain to help you protect the area and seek help. In neuroplastic pain, there’s some sort of perceived danger but no real injury. Here’s what’s important: both types are real. You are feeling pain. The difference is in the treatment. For that, Howard shares his five-part framework for reversing neuroplastic pain – and it has nothing to do with painkillers. He also reveals how the same principles can be applied to tinnitus, dizziness, brain fog, long covid, IBS, anxiety, depression, fatigue and more. We talk childhood, the personality traits that subtly make us more vulnerable to neuroplastic symptoms, and why women are so often the ones carrying the weight. Whether you're living with a long-term condition yourself, supporting someone who is, or you’re simply curious about the communication pathways between our bodies and our brains, this is an episode you won’t want to miss. #feelbetterlivemore Find out more about Dr Schubiner: Website https://unlearnyourpain.com/ Twitter https://twitter.com/hschubiner Dr Schubiner’s book: UNLEARN YOUR PAIN The Science of Recovering from Chronic Pain, Fatigue, Anxiety, and Depression US https://amzn.to/3RySyzy UK https://amzn.to/4u5Qv3s #feelbetterlivemore #feelbetterlivemorepodcast ------- Order MAKE CHANGE THAT LASTS. US & Canada version https://amzn.to/3RyO3SL, UK version https://amzn.to/3Kt5rUK ----- Follow Dr Chatterjee at: Website: https://drchatterjee.com/ Facebook: https://www.facebook.com/drchatterjee Twitter: https://twitter.com/drchatterjeeuk Instagram: https://www.instagram.com/drchatterjee/ Newsletter: https://drchatterjee.com/subscription DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Dr. Rangan ChatterjeehostDr Howard Schubinerguest
Jun 3, 20261h 27mWatch on YouTube ↗

At a glance

WHAT IT’S REALLY ABOUT

Chronic pain persists when brain learns danger, not damage signals

  1. Schubiner challenges the myth that pain always equals tissue damage, arguing that the brain interprets danger signals and can produce pain with or without injury.
  2. He distinguishes structural pain (tissue pathology) from neuroplastic pain (conditioned brain circuits) and explains why many scans and physical findings poorly predict chronic pain severity.
  3. The conversation highlights how fear-inducing interpretations of MRI results can worsen outcomes, while reassuring context can reduce pain and unnecessary procedures.
  4. Schubiner’s five-part framework—assessment, education, symptom reappraisal, emotional processing, and life changes—aims to reverse (not just manage) neuroplastic pain and related conditions.
  5. Case stories (e.g., 25 years of pain resolving in weeks, symptoms linked to grief/job loss/trauma) illustrate how awareness, safety messages, and emotional expression can rapidly shift symptoms for some people.

IDEAS WORTH REMEMBERING

5 ideas

Pain is an output of the brain, not a direct readout of tissue damage.

Signals from the body are interpreted as threat or safety; the brain may amplify or suppress pain depending on context (e.g., danger, fear, urgency), which explains injury-without-pain and pain-without-injury.

Chronic pain is often reversible because it can be learned—and therefore unlearned.

When pain persists, circuits can become conditioned loops (“neurons that fire together wire together”); changing the learned threat response can turn symptoms down or off, sometimes quickly and sometimes gradually.

MRI abnormalities commonly reflect normal aging, not the cause of chronic pain.

Findings like disc degeneration and bulges are prevalent in pain-free people; labeling them as “degeneration” can increase fear and avoidance, which can worsen pain and drive more procedures.

Interpretation and messaging can directly change outcomes.

Studies discussed show that simply reading alarming MRI language can worsen symptoms, while contextualizing findings as common/benign can prevent deterioration—highlighting the power of reassurance and accurate framing.

Use the FIT criteria to ‘rule in’ neuroplastic pain patterns.

Functional (broad/non-anatomical patterns or no clear injury), Inconsistent (shifting/on-off), and Triggered by innocuous stimuli (weather, light, sound, or even imagining an activity) are clues that the brain’s danger alarm is involved.

WORDS WORTH SAVING

5 quotes

What I always tell people is you can't understand pain unless you understand the brain.

— Dr Howard Schubiner

You can have an injury and have no pain. You can have pain without an injury.

— Dr Howard Schubiner

Pain is generated by a, a decision, that's so weird, a decision made in the brain.

— Dr Howard Schubiner

If pain, and we'll talk about anxiety, depression, fatigue, if those sensations can be learned, they can be unlearned.

— Dr Howard Schubiner

Most people will develop some form of neuroplastic condition at some point in their lives. It is simply a byproduct of being human.

— Dr Howard Schubiner

Myths about pain and structural damageBrain-based predictive processing and “danger signals”Structural vs neuroplastic pain (and overlap)MRI findings, fear, and symptom chronificationFIT criteria: Functional, Inconsistent, TriggeredPain reprocessing / symptom reappraisal techniquesEmotional awareness & expression therapy; trauma and personality traitsLifestyle and boundary changes as treatmentNeuroplastic symptoms beyond pain (fatigue, anxiety, tinnitus, POTS, long COVID)Hope, validation, and patient agency in recovery

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