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Conditions We Treat

Chronic Pain

Pain that persists beyond three months is not simply an injury that hasn’t healed. It involves changes in how the brain and nervous system process pain signals — and it responds to targeted, multidisciplinary clinical intervention.

Off-Label

rTMS for chronic pain is an off-label application in Australia, offered under psychiatrist oversight with full informed consent. Medicare rebates under MBS 14216 and MBS 14217 may apply where chronic pain coexists with treatment-resistant depression. All care is AHPRA-compliant.

Understanding the condition

What is chronic pain?

Chronic pain is defined as pain persisting for longer than three months, beyond the expected healing period of an initial injury or illness. It is a recognised medical condition — not a character failing, not a sign of exaggeration, and not always resolved by treating the original source.
The distinction between acute and chronic pain is not just about duration. Chronic pain involves changes in the nervous system itself — central sensitisation, altered pain processing, and neural circuit adaptations that can maintain and amplify pain signals long after peripheral tissue has healed. In this sense, chronic pain is as much a condition of the brain as it is of the body.
The experience varies significantly between individuals and typically involves physical, psychological, and social dimensions. Effective management addresses all three.

Common presentations include

Neuropathic pain — burning, tingling, or electric sensations arising from nerve damage or dysfunction
Fibromyalgia — widespread musculoskeletal pain with fatigue, sleep disruption, and cognitive symptoms
Musculoskeletal conditions — arthritis, post-surgical pain, or complications from injury
Central pain syndromes — following neurological events such as stroke, MS, or spinal cord injury
Post-injury and post-surgical pain — persistent pain following trauma or medical procedures

The neuroscience

Why pain becomes a brain condition

In acute pain, the signal travels from damaged tissue to the brain, serving its biological purpose as a warning. When pain becomes chronic, the neural circuitry involved in pain processing undergoes change. The brain and spinal cord become sensitised — interpreting signals as painful that would not normally be, and amplifying signals that would ordinarily be mild.
This process, called central sensitisation, explains why chronic pain can persist in the absence of ongoing tissue damage, why pain can spread beyond the original injury site, and why standard analgesics often provide only partial relief.
It also explains why neurostimulation approaches targeting the brain’s pain-processing circuits — rather than the peripheral site of pain — can be clinically meaningful for conditions where central mechanisms dominate.

Allodynia

Pain from stimuli that would not normally be painful — light touch, mild temperature changes — is a hallmark of central sensitisation.

Hyperalgesia

Exaggerated pain responses to stimuli that would normally produce only mild discomfort — the nervous system’s gain has been turned up.

Pain spreading beyond the injury site

Central sensitisation can cause pain to expand geographically — involving areas of the body that were never part of the original injury.

Our approach

How Brain Aid Clinics treats chronic pain

Management is individualised following thorough clinical assessment. No protocol is recommended before we understand your specific presentation, prior treatments, and the mechanisms most likely driving your pain.

01

Psychiatry-led clinical assessment

Thorough review of your pain history, prior treatments, psychological factors, and current functional impact. This determines the most appropriate intervention pathway and rules out other contributing conditions.

02

rTMS — neuromodulation for pain

High-frequency rTMS over the primary motor cortex (M1) or prefrontal cortex can reduce central sensitisation and modulate pain processing circuits. Evidence supports its use in neuropathic pain and fibromyalgia. Offered off-label under psychiatrist oversight, with your individual anatomy mapped using MRI-guided neuronavigation.

03

The TMF Programme

Thought, Movement, and Food. Cognitive strategies address pain catastrophising and fear-avoidance patterns. Structured physical activity supports neuroplasticity and function. Dietary quality modulates neuroinflammation. Integrated into every course of treatment at Brain Aid Clinics.

04

Collaborative multidisciplinary care

We work alongside your existing GP, pain specialist, physiotherapist, and psychologist. Chronic pain is rarely resolved by a single intervention — effective management coordinates across disciplines, and we support that coordination actively.

Clinical evidence for rTMS in chronic pain

Systematic reviews and controlled trials demonstrate analgesic effects of rTMS over the motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) in neuropathic pain and fibromyalgia. A 2022 RCT showed 66.6% of fibromyalgia patients achieved ≥30% pain reduction with DLPFC-targeted rTMS. rTMS is not Medicare-eligible for chronic pain in Australia (funding is limited to treatment-resistant depression) and is offered here off-label under specialist oversight. Individual outcomes vary.
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Common Questions

What patients ask us

What is the difference between acute and chronic pain?
Acute pain is a biological warning signal — it arises in response to injury or illness and typically resolves as the underlying cause heals. Chronic pain persists beyond three months and often beyond the resolution of the initial injury. The key difference is neurobiological: chronic pain involves changes in how the nervous system processes pain signals, including central sensitisation, that can sustain and amplify pain independently of peripheral tissue damage. Management therefore focuses on improving function, quality of life, and pain regulation — not simply on treating the original injury site.
Standard analgesics are most effective for pain driven by peripheral tissue damage. When chronic pain is maintained by central sensitisation — changes in the brain and spinal cord’s pain-processing systems — peripheral approaches often provide only partial relief. This is not a sign that the pain is imagined or exaggerated. It reflects that the primary mechanism driving the pain has shifted from the peripheral site to the central nervous system, and that targeting the central circuits may be more effective.
rTMS delivers focused magnetic pulses to specific cortical regions involved in pain processing — primarily the primary motor cortex (M1) and the dorsolateral prefrontal cortex (DLPFC). By modulating the activity of these circuits, rTMS can reduce central sensitisation and alter the brain’s pain-processing gain. The evidence base is strongest for neuropathic pain and fibromyalgia. At Brain Aid Clinics, stimulation targets are mapped to your individual brain anatomy using MRI-guided neuronavigation, improving accuracy and reproducibility across sessions. rTMS for chronic pain is off-label in Australia and is offered under psychiatrist oversight with full informed consent.
Medicare rebates for rTMS (MBS 14216 and MBS 14217) are currently limited to treatment-resistant depression in Australia. rTMS for chronic pain is not Medicare-funded as a standalone indication. However, where chronic pain coexists with treatment-resistant depression — which is common — Medicare rebates may apply to the depression component of treatment. WorkCover, TAC, DVA, and CTP funding pathways are also available in some cases. Our team can discuss your specific circumstances at assessment.
Yes — through well-characterised mechanisms. Regular physical activity reduces neuroinflammatory markers and supports neuroplasticity in pain-regulatory circuits. Dietary quality influences the inflammatory environment in which the nervous system operates. Sleep disruption is both a consequence of chronic pain and a driver of central sensitisation — improving sleep architecture directly affects pain thresholds. Psychological approaches — particularly CBT and graded exposure — address fear-avoidance and pain catastrophising, both of which amplify the subjective experience of pain and reduce function independently of pain intensity. These are not alternative or complementary to clinical treatment; they are part of it.
Your first appointment is a clinical assessment — not a treatment session. Your treating clinician will review your pain history in detail: the original injury or trigger, prior treatments and their outcomes, current functional impact, and what you are hoping to achieve. The goal is to understand the mechanism most likely driving your pain before recommending any intervention. Where rTMS is clinically appropriate, the protocol and realistic expectations are explained clearly before you commit to a course of treatment.
Clinical and regulatory note: rTMS for chronic pain is an off-label application in Australia, offered under psychiatrist oversight with full informed consent. Medicare rebates (MBS 14216, MBS 14217) apply for treatment-resistant depression only. All information is for general informational purposes and does not constitute medical advice. Please consult a qualified health professional. Brain Aid Clinics operates within AHPRA-compliant clinical and regulatory boundaries. ABN 76 664 676 420.

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