If you've bought three different ergonomic pillows, adjusted your monitor 47 times, purchased a chair that promised to "change your life," and rearranged your entire desk setup...only to wake up with the same sore neck the next morning, I see you.
Maybe you've even reached the point where you eye every pillow in your house with suspicion.
When you're dealing with chronic neck pain, it's incredibly frustrating to keep trying things that are supposed to help without getting lasting neck pain relief. You've adjusted your posture, changed your workspace, stretched your neck, tried physical therapy, bought the fancy pillow, and maybe even started sleeping in positions that require the flexibility of a Cirque du Soleil performer.
And yet, there it is again: the familiar neck tension, stiffness, aching, or pain that seems to have taken up permanent residence.
When Ergonomics Don't Relieve Chronic Neck Pain
Ergonomics can absolutely matter. If your workstation is contributing to muscle strain or discomfort, changing your setup may be helpful. Physical therapy can also be an important part of treatment for many types of neck pain.
But what happens when you've addressed all of those things and your sore neck still hurts?
Chronic neck pain can start affecting almost every part of your life. Maybe you can't exercise the way you used to, which leaves you feeling more sluggish or down. Maybe your sleep suffers because you can't find a comfortable position. You may become less active, gain weight, rely more heavily on pain medications or muscle relaxers, or dread spending another eight hours in front of a computer.
And then a frustrating cycle can develop: less activity leads to worse mood, worse sleep, and more physical tension—which can make the pain feel even more persistent.
At some point, you may start wondering, "What on earth is actually causing this?"
What If Your Neck Pain Isn't Coming From Your Desk?
Here's where things get interesting.
For some people, chronic pain can become neuroplastic, meaning the nervous system learns to produce pain even after the original source of danger has resolved. This doesn't mean the pain is imaginary or "all in your head." Quite the opposite: neuroplastic pain is very real pain generated by the brain and nervous system.¹
Sometimes there's an obvious starting point. You may have experienced whiplash, an injury while exercising, or months or years of physical strain from working at a computer. The original injury may heal, but your brain's danger system can remain on high alert, continuing to interpret certain sensations as threatening.
For others, the nervous system may become sensitized during a period of significant emotional or physical stress. A death in the family, the relentless demands of parenting, problems at work, chronic stress, or a history of trauma can all contribute to a nervous system that is already operating with its "danger dial" turned way up.
Then you experience pain.
Naturally, you go looking for an explanation. You see a physical therapist. You Google ergonomic chairs. You research the "perfect" sleeping position at 1:00 a.m. because apparently sleep is optional when you're worried about your neck.
But nothing seems to provide lasting relief.
Neuroplastic Pain Doesn't Mean You're Stuck With It
If your chronic neck pain has a neuroplastic component, that can actually be good news.
It means your pain isn't necessarily evidence that your body is permanently damaged or that you need to spend the rest of your life avoiding every activity that might possibly irritate your neck.
Your brain and nervous system are capable of change. Just as the nervous system can learn to become overly protective, it can also learn that certain sensations and activities are safe. This ability of the nervous system to change based on experience is known as neuroplasticity.¹
And most importantly, none of this is your fault.
Your brain isn't betraying you. It's trying to protect you. It has simply become a little overzealous about its job. Think of it as a smoke alarm that has become so sensitive that it goes off when you make toast. The alarm (pain) is real. The problem is that there isn't actually a house fire, just some slightly browned toast.
How Pain Reprocessing Therapy Can Help Chronic Neck Pain
Pain Reprocessing Therapy (PRT) is an approach designed to help people understand and retrain the brain's pain and threat responses.
Rather than spending your entire life trying to avoid every possible trigger, PRT helps you learn to interpret sensations with less fear and threat. Through pain neuroscience education, somatic awareness, and working with the thoughts, emotions, and behaviors that can keep the nervous system on high alert, you can begin teaching your brain that your body is safer than it thinks (sort of like training the dog that the mailman is not actually a dragon you must be protected from).
Research on PRT has shown promising results for chronic primary pain, including a randomized clinical trial in which participants receiving PRT experienced substantial reductions in chronic back pain compared with control treatments.² While research specifically on chronic neck pain is still developing, the principles of neuroplastic pain treatment may be relevant for people whose persistent neck pain has this component.
That distinction matters: PRT isn't about convincing yourself that your pain isn't real. It's about helping your brain stop sounding the alarm when you are actually safe.
You Don't Have to Keep Chasing the Perfect Pillow
If you've been living with chronic neck pain and feel like you've tried everything, it may be worth considering whether your nervous system—not just your posture, pillow, or workstation—could be part of the picture.
As a therapist trained in Pain Reprocessing Therapy, I help clients understand the connection between their nervous system, emotions, and chronic pain. You can learn more about how I help clients find lasting relief from chronic neck pain and other forms of chronic pain through therapy and coaching.
And if you're tired of trying to solve your neck pain by purchasing yet another pillow (please, for the love of your cervical spine, put down the Amazon app), I offer free consultation calls where we can talk about your symptoms, what you've tried, and whether Pain Reprocessing Therapy might be a good fit for you.
You don't have to figure this out alone.
References
¹ Moseley GL, Flor H. Targeting cortical representations in the treatment of chronic pain: a review. Neurorehabilitation and Neural Repair. 2012.
² Ashar YK, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care on Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022.