07/27/2026
Pain is not just a nervous system problem.
It is a conversation between the tissues, immune system and nervous system.
A fascinating new review explains that this conversation happens along the entire pain pathway.
In the tissues.
Around peripheral nerves.
Inside the dorsal root ganglia.
Within the spinal cord.
And all the way into the brain.
Immune cells release chemical messengers that can change how sensitive and excitable nociceptive neurons become.
But the conversation goes both ways.
Nociceptive neurons also release Substance P and CGRP that influence immune activity and inflammation.
In acute injury, this communication can be protective. It helps identify a problem, protect the area and support repair.
But when that conversation fails to resolve, it may help keep the nervous system sensitive long after the original injury has changed.
This is why persistent pain cannot always be explained by a tight muscle, damaged tissue or an ugly scan.
And it certainly cannot always be solved by rubbing harder.
Pain is biological.
It is neurological.
It is immunological.
And the better therapists understand the conversation, the more intelligently we can choose our input.
The science of pain is getting much bigger than muscles.
It is about time our treatments did too.
