Rewiring Pain: Comprehensive, Evidence-Based Strategies to Reduce Chronic Pain and Medication Dependence

Chronic pain is complex, but there is hope. Modern research shows that pain is not always a sign of damage — instead, it can be a sign that the nervous system has become overactive and hypersensitive.

This is especially true in conditions like fibromyalgia, neuropathy, chronic low back pain, and post-surgical pain. At Horizon Spine & Pain, we use a multi-layered approach to help you regain control, reduce reliance on opioids, and improve your quality of life.

Cognitive Behavioral Therapy (CBT)

CBT is a practical, research-supported therapy that helps people identify and shift thoughts, behaviors, and habits that can unintentionally increase pain and stress. You're not being told the pain isn't real — you're being offered tools to respond to it differently and more effectively.

CBT can help you:

• •Understand how thoughts and behaviors influence pain
• •Reduce fear of movement or worsening symptoms
• •Re-engage in meaningful activities you've been avoiding
• •Build confidence that you can manage pain over time

Mindfulness-Based Strategies

Mindfulness teaches you to pay attention to the present moment without judgment. It helps reduce overreaction to pain and can calm the nervous system. It's a valuable way to build emotional and physical resilience.

Examples of mindfulness practices include:

• •4-7-8 Breathing: Inhale for 4 seconds, hold for 7, exhale for 8 — repeat 4–5 times. Try it when you first wake up or before sleep
• •Body Scan Meditation: Slowly notice each area of your body from head to toe. Try it lying down with your eyes closed for 5 minutes before bed
• •Mindful Walking: Walk slowly and focus on each step and your breath. Try it for 5–10 minutes after lunch or dinner

Ketamine Infusion Therapy

Ketamine is a medication that can help "reset" overly sensitive pain pathways in the brain and spinal cord. It works differently from opioids and has been shown to help with nerve pain, fibromyalgia, complex regional pain syndrome (CRPS), and other centralized pain conditions.

Ketamine may also help reduce opioid use in patients who have tried other therapies without success.

Other Evidence-Based Tools

Gentle Exercise

• •Regular movement — even low-intensity — reduces inflammation and improves mood
• •Walking, stretching, yoga, or water-based exercise can help recondition the body safely
• •Start slow, increase gradually, and pace yourself to avoid flare-ups

Pain Neuroscience Education (PNE)

• •Learning about how pain works can help reduce fear and give you more control. The brain interprets pain, so understanding this process can actually reduce pain intensity
• •Watch short videos like Tame the Beast or Why Things Hurt
• •Remind yourself that pain doesn't always equal harm
• •Knowledge can help reframe the experience of pain — and reduce it

Anti-Inflammatory Diet & Supplements

• •Choose whole foods over processed ones. Focus on vegetables, fruits, fish, and nuts
• •Reduce sugar, refined carbs, and soda where possible
• •Supplements like magnesium, vitamin D, omega-3s, and turmeric may support your recovery — check with your provider first

Acceptance and Commitment Therapy (ACT)

• •Focus less on eliminating pain, and more on doing what matters — even with pain
• •Clarify your values (family, faith, purpose) and make small daily choices that align with them
• •Learn to notice difficult thoughts without getting stuck in them

Team-Based and Multidisciplinary Approaches

Programs that combine physical therapy, mental health support, medical care, and interventional treatments often lead to the best results. You don't have to do this alone — building a care team around you is part of long-term success.

Getting Started: What You Can Do Today

Start small. Try one or two strategies from this handout — like practicing mindful breathing in the morning, writing down one helpful thought, or going for a short walk. With consistency, these tools can help you turn down the volume on pain.

We're here to support you at every step. Talk with us about building a plan that fits your needs — including therapies, procedures, and safe medication adjustments if needed.

Examples in Practice

• •Understand how thoughts and behaviors influence pain: Noticing that when you think "I'm falling apart," your pain seems worse — and learning to shift that thought to something more helpful like, "This is difficult, but I've managed before."
• •Reduce fear of movement or worsening symptoms: Instead of avoiding walking out of fear of hurting yourself, start with a slow 5-minute walk and build from there as your confidence grows.
• •Re-engage in meaningful activities you've been avoiding: Scheduling a short phone call with a friend or attending a low-stress social activity, even if some discomfort is present.
• •Build confidence that you can manage pain over time: Keeping a small journal where you note one positive thing you did each day despite the pain — like cooking, stretching, or needing less medication.