02/15/2026
How pelvic floor therapy helps pelvic pain; it addresses the nervous system.
🧠 The ‘Pain Nerves’ Story, and why it keeps therapists stuck
Most of us were trained in a simple storyline 🧩. Something is wrong in the tissues, that problem irritates ‘pain nerves’, then a pain message travels to the brain, and pain is the conscious experience of that message.
From there the logic feels obvious 🙌. If pain is coming from the tissues, the job is to change the tissues. Stretch, release, mobilise, melt the restriction, remove the knot, and you change the input, so the pain stops. Some trainings even imply pain is 'trapped' in tissue, and skilled hands can release it.
That belief makes sense because it fits what you see in clinic 👀. People point to a specific spot. Symptoms can change during touch. One therapy session can reduce pain. If your training told you that means you changed the tissue problem, you will naturally assume you changed the pain source.
Here is the issue 🔍. There are no ‘pain nerves’ that carry pain. What we actually have are nociceptors, specialised sensory endings in tissues that respond when conditions suggest potential tissue threat, such as strong mechanical loading, extremes of temperature, or chemical irritation linked with inflammation. When nociceptors activate, they send nociceptive input, meaning incoming information about potential threat, not pain itself.
Pain is different ⚠️. Pain is a protective experience the brain constructs when it judges protection is needed. Nociceptive input can influence that judgement, especially in acute injury, but it is not the same thing as pain. This is why the idea of ‘releasing pain from tissue’ is not accurate. You cannot extract pain like a substance, because pain is not stored in fascia, stuck in scar tissue or trapped in muscle.
If the brain worked like a simple receiver 📥, it would need to process vast amounts of raw information from the body and the outside world, every moment, then build perception from scratch. It would need much more capacity than we have. The brain is also metabolically expensive. It is a small part of body weight, yet it uses a large portion of the body’s energy at rest. That cost only makes sense if the brain is doing something efficient.
This is where predictive processing comes in 🧠➡️. The brain is not a simple receiver, it is predicting the future. It continually generates best guesses about what is happening and what is likely to happen next, then checks incoming sensory information to update. It does not run one prediction only. It runs multiple predictions at once, then settles on the one that it judges as the best guess estimate with the least energy cost. That is efficient, and efficiency is survival.
Now link that back to pain 🔁. If the brain predicts threat, it will often shift the body towards protection. That can include guarded movement, increased muscle tone, changed breathing, increased attention to sensations, and yes, pain. This is why pain can change fast. When the brain updates threat level, the protective response can change fast too.
So what does this mean for hands on therapy 👐. Touch can still help, but the explanation changes. We do not ‘fix’ tissues in the way we were taught, as if we are correcting a fault and removing pain from a structure. Touch is information delivered in a context. When that context supports safety and control, the nervous system may lower threat prediction, and protection can soften. That is not ‘melting' or 'releasing' tissue to remove pain’. It is shifting the brain’s best guess about danger.
Feet on the ground conclusion ✅. Pain is real. Bodies are real. Nociceptive input is real. But pain is not trapped in tissue waiting for release. Pain is a protective experience constructed by a predictive brain, and good therapy supports safer predictions, not tissue mythology.
