How Somatic Therapy Fits into Your Chronic Pain Treatment

Where Does Somatic Therapy Fit in Your Chronic Pain Treatment?

Many people come to somatic therapy having heard it can help with chronic pain.

Someone close to them mentioned it, or they read about it online.

But they're left wondering how is somatic therapy going to help them, and where does it fit with everything else they're doing?

Most people that I work with are experiencing some form of chronic pain. And somatic work does support with the treatment of pain conditions, but we need to be clear on what role somatic therapy plays.

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Chronic Pain is Exhausting.

Whether you're navigating fibromyalgia, endometriosis, pelvic pain, vulvodynia, TMJ, IBS, unexplained aches and pains or autoimmune conditions - you might be turning to somatics to find relief in the midst of conflicting answers, endless appointments, different diagnoses and treatments.

I want to say right from the start - somatic therapy won't replace your medical team, but it does address what is often a missing link in pain treatment.

And that's the role of your nervous system in maintaining, amplifying and perpetuating pain.

What is Chronic Pain?

Chronic pain is classified as pain experienced for over 3 months that no longer serves a purpose - it might be lasting pain after an injury has fully healed, migrating pain that seems to have no cause, or pain that shows up when you're stressed.

Different Types of Pain

There are three types of pain according to current pain research:

Nociceptive pain is the 'functional' pain that we experience during an injury, or when our body is telling us something is dangerous - it serves a protective purpose, signals tissue damage, and goes away after the tissue has healed.

Neuropathic pain signals damage to the nervous system itself - the brain, the spinal cord, or peripheral nerves. This can result from conditions like neuropathy, nerve compression, or autoimmune disorders. This is the type of pain your medical team is best equipped to diagnose and treat

Neuroplastic pain is also known as 'learned pain.' This is where there's no ongoing tissue damage and no nerve lesion, but your experience of the pain is real and often debilitating. This pain moves around, it's elusive, and it's the most common pattern underlying chronic pain conditions.

Neuroplastic pain can increase the impact of other types of pain because of the sensitization and increased threat response, and it is the layer we have the most opportunity to treat together.

What is Central Sensitization Syndrome?

Central sensitization is a state where your nervous system becomes hyper-sensitized to pain - it involves changes in your body's perception of what is painful (things that usually wouldn't hurt cause pain, like soft touch). You might also notice you're highly sensitive to sound, light, scent, and things that aren't typically understood as painful.

It's like the volume dial of your pain processing system is turned up.

Not only are there changes in nerve communication but also the areas of your brain that register pain. In addition, your body's ability to send signals that dampen pain is impacted, so it's not just that the dial is turned up, but it's also harder to turn off.

Conditions often associated with central sensitization include fibromyalgia, irritable bowel syndrome, interstitial cystitis, temporomandibular joint disorder (TMJ), endometriosis, pelvic pain, migraines, complex regional pain syndrome, and many forms of chronic back and neck pain. Often these conditions overlap, and people find themselves with multiple diagnoses that all share this underlying nervous system pattern.

One key feature of central sensitization is the connection between pain and threat. The more the nervous system interprets pain as dangerous, the more the threat response amplifies the pain signal, which increases the sense of danger, which amplifies the pain further.

This initially comes as heavy news for people who are already struggling to manage pain. However, it can also be empowering to know that we can interrupt that loop and use the power of neuro-plasticity to support positive changes in the pain processing system.

☝️ THIS is what we're working with in somatic therapy: mindfulness, graded exposure / desensitization, stress management, and nervous system regulation.

Watch: How you think about your pain changes the way it feels

Where Somatic Therapy Helps with Chronic Pain

Somatic therapy doesn't treat the underlying medical condition, but it works with the nervous system's experience of that condition. This is an important distinction, and it's worth being clear about.

If you have endometriosis, we are not treating the tissue pathology. If you have fibromyalgia, we are not targeting the condition directly.

What somatic therapy addresses is the sensitization layer - the nervous system dysregulation, the threat-pain cycle, the hypervigilance toward body sensation, and the bracing and avoidance patterns that develop when your body has felt like an unsafe place for a long time.

This matters because for many chronic pain conditions, the sensitization layer is where a significant amount of suffering lives. And it is a layer that most conventional treatment (medication, physiotherapy, even CBT) does not address directly.

What somatic therapy specifically offers:

• Interrupting the threat-pain cycle

• Rebuilding a relationship with body sensation (because when you've been in pain for a long time, your body stops feeling like a safe place)

• Developing interoceptive awareness (the ability to sense your body from the inside with curiosity and neutrality rather than dread)

• Nervous system regulation: moving your system out of chronic threat states towards restorative states

• Identifying and working with underlying survival responses, bracing patterns, and emotional suppression

• Building empowering skills for managing flare-ups: grounding, orienting, breathing, and self-regulation tools you can use between sessions and at home

It's not exactly accurate to say we treat pain by "releasing" trauma from the body, though people often find that symptoms shift when we address underlying survival responses and suppressed emotional states.

In the context of chronic pain, the primary focus is building your nervous system's capacity to feel safer: less reactive, less threat-activated, more able to be present with sensation without it cascading into anxiety or despair.

What We Might Actually Do in Sessions

Treatment looks different depending on your pain presentation, nervous system state, trauma history, and goals. Some sessions are more movement-based; others are more conversational and awareness-oriented. We move between them as needed.

Approaches I draw from include:

• Somatic tracking (gently bringing non-threatening awareness to body sensations, interrupting the threat response rather than reinforcing it)

• Clinical Somatic Exercises: movement-based practices that address chronic muscle tension, nerve compression, and postural holding patterns contributing to pain (particularly useful for conditions like thoracic outlet syndrome, pelvic floor tension, and chronic back pain)

• Orienting and grounding (using the present-moment environment to signal safety to the nervous system)

• Mindfulness and diaphragmatic breathing (regulated breath is one of the most direct pathways to nervous system state change, and helps reorganize your tissues from the inside out)

• Awareness of posture & bracing (identifying unconscious holding patterns that maintain tension and pain)

• Trauma renegotiation and inner child work (where underlying emotional material is maintaining the system in a chronic threat state)

For more on clinical somatic exercises and neuroplasticity-based approaches to pain: Neuroplasticity and Chronic Pain - Somatic Movement Center

What to Expect Over Time

Working with chronic pain through somatic therapy is a gradual process. We go slowly, particularly at the beginning, when the goal is simply to rebuild your relationship with your body and build more access to pleasant or neutral sensations alongside the difficult ones.

Over time, people working this way often report things like: less automatic catastrophizing during flare-ups, more moments of ease and physical comfort, greater ability to interrupt anxiety spirals, and a growing sense that the body is somewhere they can return to rather than escape from.

This kind of work requires repetition and patience. Nervous system retraining is incremental, and it isn't a quick fix.

So knowing all of this, you can see that somatic therapy is profoundly supportive for chronic pain, but chronic pain also requires interdisciplinary support.

Somatic therapy works best as part of a broader treatment picture that may include your physician, physiotherapist, pain specialist, or other practitioners.

My role in that team is the nervous system piece: the part of your experience that is shaped by how your body has learned to interpret and respond to sensation. The underlying threat responses and traumatic experiences that have contributed to ongoing bracing and activation.

For a broader overview of evidence-based treatments for central sensitization: Central Sensitization Syndrome Treatments - Hinge Health

Ready to Explore Whether This Is the Right Fit?

If you're living with chronic pain and you're curious about whether somatic therapy could be the missing piece in your treatment team, I'd love to connect.

I offer a free 20-minute consultation where we can talk about what you're experiencing, what you're looking for, and where somatic work might fit into your big picture. There's no pressure and no commitment, just a conversation to help you figure out whether this is the right next step.

Book a free consultation >>

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References & Further Reading

Dydyk AM, Chiebuka E, Stretanski MF, et al. (2025). Central Pain Syndrome. In: StatPearls [Internet]. NCBI.

https://www.ncbi.nlm.nih.gov/books/NBK553027/
Central Sensitisation - Physio-Pedia
Neuroplasticity and Chronic Pain - Somatic Movement Center
Sentral Sensitization Syndrome: Treatments - Hinge Health
How you think about your pain changes the way it feels (video)