Why Chronic Pain Programs Fail — and How You Can Get Better Results

If you’re reading this, there’s a good chance you’re asking yourself a hard question: What if I commit to another chronic pain program and it still doesn’t work?

That fear is reasonable. Most of the people who find us have already tried physical therapy, injections, medications, supplements, surgeries, alternative therapies, or all of the above. They’re not new to pain care. They’re tired of investing time, energy, and money without lasting change.

We learned the hard way, after working with hundreds of patients, to know that when a program doesn’t help, the outcome is rarely random. It comes down to either poor quality care, misconstrued expectations, or a lack of active participation by the patient.

This article is here to be honest about those conditions.

I’m going to walk you through the most common reasons the True Health Chronic Pain Program is unsuccessful for some people and how to avoid them. Don't let the length of this article be an automatic deterrent. We are just thorough in our work.

The Primary Driver of Your Pain Is Not Modifiable (or Not Yet)

One of the most important—and least discussed—reasons a chronic pain program can fall short is that the main driver of pain isn’t something we can meaningfully change right now.

A more obvious example would be that you are recovering from a recent surgery or a more intense injury. While we are very capable at helping you make a quicker and more complete recovery than you likely would on your own, spending valuable program time focused on these issues could hinder overall results.

Less obviously, there are situations where pain persists because a constant, overwhelming input is still present. Examples include ongoing toxic exposure, such as active mold or heavy metals in the home or workplace that hasn’t been remediated. While these are things we would be treating during your program, it will be impossible to treat fully.

That doesn’t mean improvement is impossible. But it does mean expectations have to match reality. If you can wait to start your program after these foreseeable issues are resolved, great. If not, we would have a discussion about a more realistic healing timeline for you, and adjust your treatment plan accordingly.

A 37 year old patient with CRPS broke her leg two weeks into our program. Given the nature of her condition, her history of delayed healing, and this unfortunate injury, we decided that now was not the best time for her to be undergoing such an intensive program. We paused her program and focused on healing her broken leg bone as quickly and thoroughly as possible.

Nutritional or Lifestyle Recommendations Are Not Followed Consistently

We are not treating pain here. We are treating the things that are causing your pain and this takes a lot more time and effort than popping a pill. This is 100% going to require you to make nutritional and lifestyle improvements. These things are the foundation of human health and are absolutely necessary to achieve remission from chronic pain.

Changing your diet, retraining your sleep, and clearing your house of inflammatory chemicals flat out sucks. These changes can surely be uncomfortable if you are set in your ways. However, none of it is unrealistic. We would never ask you to do something that you couldn't due to any limitations you have. Nor would we ask you to do something that we wouldn't do ourselves. We are masters at guiding individuals through this process and can ensure you will feel much better in the end.

A patient of ours suffering from lifelong migraines refused to give up gluten for the first four months of her program despite a food sensitivity test showing she was highly sensitive to it. After four months she finally decided to eliminate it from her diet and instantly felt better. Over the next two months she made quicker improvements than the first four combined. While she still left our six month program feeling the best she ever had, and had all the tools to keep treating herself, we were not able to achieve full remission in that time frame due to her initial reluctance.

Emotional or Psychological Contributors Are Present but You’re Unwilling to Work on Them

Although it may certainly feel like it, chronic pain is not “all in your head.” But it does live in a nervous system that learns, predicts, and protects based on experience.

Repressed emotions, unresolved trauma, ongoing relational conflict, or catastrophizing thoughts all feed chronic pain. Not because pain is psychological, but because emotional stress directly amplifies pain processing on a physiological level.

Every chronic pain sufferer has emotional contributors to their pain. If you think this doesn't apply to you then I ask, "are you fearful of your pain?" Are you fearful that certain movements or activities will worsen your pain? are you fearful that if you overdo it today you will be wrecked for the next week? We know the impact that emotions play on chronic pain, especially the pain-fear cycle.

One of the most beneficial therapies included in the True Health Chronic Pain Program is mind-body counseling. A unique treatment that helps uncover repressed emotions and ties them to the physiology that is keeping you in a chronic pain state.

One of our most complicated cases was a middle aged man who was living with fibromyalgia for 15 years. After his initial intake and advanced laboratory testing we quickly realized the problem was even more complicated than we thought. Luckily, he was real ambitious, adhered to his treatment plan perfectly, and was 75% better in 6 months. But this is where he plateaued because he was unwilling to dive into his childhood trauma, which was clearly driving his pain, no matter how much we showed him the connection.

You Don't Submit Your Labs In A Timely Manner

We do not draw any labs in office. Most of the advanced laboratory tests we utilize are at home test that you mail in yourself. The collection process is easy and straightforward and results are usually available within two weeks of the lab receiving your sample.

We are able to start making some nutritional and lifestyle recommendations before we receive your lab results and we can get started with other therapies. However, we cannot make any more specific recommendations to your treatment plan until we have all of your lab results in hand.

There are various reasons why someone might not submit their labs in a timely manner:

• You fail to make a plan. Some tests require you to collect your sample at certain times of the day or month. Or you forget that you needed to fast.

• You forget to schedule a pickup or drop your sample off at the post office, FedEx, UPS, etc.

• You don't want to prick your own finger for blood tests or collect your own stool sample.

• You waited too long to ship your sample that by the time it gets to the lab it has expired and we have to start the whole process over.

• You do not fill out all the paper work thoroughly which delays sample processing at the laboratory.

• You do not make an appointment for tests that require you to go to a local draw site.

We had a patient once that refused to send in her food sensitivity test. She completed all her other tests in a timely manner but not this one. She feared the results would come back telling her that her favorite foods were driving her chronic inflammation. She went through the entire program believing that what she didn't know wouldn't hurt her. As you can expect, after 6 months she felt a lot better but not as good as she could have. A couple of months after the completion of the program she felt a plateau. She decided to finally submit her food sensitivity test. While she was not reacting to her favorite foods she was reacting to some she commonly consumed. Eliminating those from her diet allowed progress to resume.

Expectations Are Unrealistic or the Time Horizon Is Too Short

You've been living with chronic pain for so long now that you understand that results do not come quickly. However, our conventional model of medicine has trained us to expect quick results with the pop of a pill. So, sometimes, quick results are still expected considering how radically different the True Health Chronic Pain Program is compared to everything else you have tried.

The True Health Chronic Pain Program is not designed to provide quick results. It is designed to provide lasting results. Setting realistic expectations early on helps prevent discouragement.

• Making nutritional and lifestyle changes takes time. Furthermore, it takes time for these changes to take noticeable effect. You may not notice improvements for the first couple of months depending on how quickly you adhere to your treatment plan.

• Certain conditions like autoimmune disease and mold toxicity take much longer to treat. It takes about 4 months of prep work before we can safely fight mold toxicity. Otherwise we risk flares.

• Fares are to be expected. We don't see them as failure, but rather use them as data to better tailor your treatment plan to you.

• Improvement is not linear. You may feel bursts of rapid improvements followed by periods of regression. It happens to everyone.

Over the years treating chronic pain, we have noticed that the first 80% or so of recovery comes much quicker than the last 20%. For most of our patients, that 80% mark happens around 6 months. Which is not a lot of time, especially considering how long you have been living with your chronic pain.

You’re Expecting Quick, Passive Results Instead of Taking an Active Role

You've likely already tried everything conventional medicine has to offer chronic pain sufferers. Outside of physical therapy, all the treatments were probably quick and passive. Meaning you just showed up to your appointment, received your medication, injection, or operation and that was it. One of the benefits of pharmaceutical interventions is that they are often quick acting, especially pain medications. But how well did they last and work overall?

We know that active treatments yield much better outcomes than passive treatments 

Our program is not something that happens to you. It’s something you participate in. It is largely based on education so that you understand the inner workings of everything that is contributing to your pain, how each treatment works, and how you can continue to treat yourself after your program has ended.

But we understand that this is not for everyone which is why we always start with a free phone consult to learn more about you, your needs, and to outline the program so that expectations are realistic and you are not signing up for something you are unable to actively participate in.

We want you to experience remission of your chronic pain but we don't want to waste your time and money either. If we do not think you would be able to achieve the results we are capable of producing then we will be honest with you about that. We turn away more people than we accept into the True Health Chronic Pain Program because they are looking for quick results and passive treatments.

You’re Focused Only on Your Diagnosis, Not Your Whole Body

There's a paradox to receiving a medical diagnosis. On one hand it can provide tremendous relief. A lot of chronic pain sufferers go a long time before receiving a diagnosis. When this happens you can take a sigh of relief in the comfort that you finally know what the issue is. On the other hand, a diagnosis can lead to poorer care. Once you receive a diagnosis you are much less likely to receive individualized care and instead receive the standard of care for your diagnosis. The same treatment that everyone else with your diagnosis receives. Furthermore, now that your doctor "knows what the problem is" they may be more reluctant to do any more testing for other underlying issues.

At True Health Centers we do not treat your diagnosis. We don't treat your pain either. We treat you, and that makes all the difference. Because treating someone with chronic pain means treating all of them. All of the physical, biochemical, and emotional causes of their pain. We are so proud of our True Health Chronic Pain Program because it doesn't just help people get out of pain, it helps them be healthier overall so that they can enjoy their life free of chronic pain.

It really "clicks" for patients that the True Health Chronic Pain Program is truly different than anything else they have tried for their chronic pain when we start asking about gut health, dental health, sexual health, possible mold exposures, your childhood, etc. during the initial intake. I order to treat the whole you we need to get to know the whole you first.

You’re Dismissive of Certain Treatments Because You’ve “Already Tried Them”

This is one of the most common and understandable reactions we see.

People come in saying, “I’ve already tried supplements,” or “I’ve already seen a chiropractor.” What they often mean is that they’ve tried those things in isolation.

There are two reasons why a treatment didn't work for you in the past, but we may prescribe it anyways.

1. Not all supplements, and not all practitioners are the same. There is noticeable difference between the supplements you can get at the store and those that require a medical license to purchase. Likewise, the skillset and treatment offerings of your practitioner vary widely.

2. While most treatments have their merits individually, they are almost always less effective in isolation. Each treatment is just one piece of your chronic pain puzzle; producing better results when combined together.

The human body works as a connected unit. Your organs and body systems are not isolated. They are in constant communication and collaboration with each other on a physical, biochemical, and emotional level. To separate these would undermine human physiology.

During a free phone consult a prospective patient was going on and on about how she didn't like chiropractors because she always felt worse after her appointments. Once I could get a word in I reminded her that, in addition to being a naturopathic doctor, that I was also a chiropractor. The line comically went silent and then I explained to her that not all chiropractors are the same philosophically or in skill. I then proceeded to explain why her isolated chiropractic appointments were unlikely to ever fix her chronic pain and why combining it with our other treatment options would likely produce different results for her. She was ultimately deemed a good candidate for the True Health Chronic Pain Program and she started the next week.

You Measure Success Only by Pain Levels

Pain intensity is one data point. It’s not the whole story.

Early success in chronic pain programs often shows up as better sleep, improved energy, faster recovery after flares, increased tolerance for activity, or less fear around movement.

Pain reduction often follows these changes. Not the other way around.

When success is measured only by daily pain scores, real progress can be missed, and motivation drops prematurely. The nervous system interprets constant monitoring as threat, which can actually amplify pain output.

Programs don’t fail here because nothing is changing. They fail because the wrong signals are being tracked.

This is not uncommon, but a prominent example of this came from a 63 year old patient with chronic low back pain. His pain was so bad that he would only leave the house about once per week due to the consequences of a flare up. By the second month of the program he was feeling discouraged because his pain rating had only dropped one point. But he had missed the fact that he was now coming to us three times a week without eliciting a flare up. It wasn't until about the fourth month, after his sleep improved, his digestion normalized, and his mobility increased, that substantial improvements in his pain were felt.

The Program Works — but There Is Relapse Afterward

Remission takes two things:

1. Time

2. Continual treatment

6 months is a short period of time relative to how long your chronic pain has been developing. We know it is unrealistic for every patient to achieve remission in that timeframe. Which is why we prioritize education throughout the entire program. We make sure you understand everything there is to know about your pain, why each treatment works, and when to implement it so that you can keep treating yourself long after you are done with the program.

Chronic pain is not the chicken pox. If you fall back into the same habits that got you into chronic pain to begin with, it will return. This is an unfortunate inconvenience, but so is health in general. It takes continuous work to feel our best, irregardless of pain.

In the past we have had patients who have signed up for another round of the program, others who continuously come in for regular maintenance appointments, some who come in a couple times a year when they need it, and a few who have cut their reliance on us and their doctors almost completely. Either way, the end of your program is not goodbye. We are always in your corner, keeping tabs on you and here whenever you need us.

What to Do Next If You’re Considering This Program

If you’ve made it this far, you’re likely someone who wants understanding, not promises.

The next step isn’t commitment—it’s clarity. A discovery call allows us to briefly look at your history, your needs, your expectations, and your capacity right now. Sometimes that leads to working together. Sometimes it leads to a different recommendation or a different timeline.

Either way, the goal is the same: helping you make an informed decision.

If you’re ready to explore whether this approach fits your situation, schedule a free phone consult to have all your questions answered.

Schedule Online

Written By:

Dr. Jason Winkelmann

Chronic Pain Specialist and Educator

Frequently Asked Questions

What does it mean if the program doesn’t help someone fully resolve their pain?

Not every case of chronic pain resolves completely in a set timeframe. Some factors—such as ongoing exposures, unmodifiable medical conditions, or deeply entrenched nervous system patterns—can limit how much a person improves. When full resolution isn’t possible, the program still aims to reduce suffering, improve function, and give patients tools to manage pain more effectively long term.

What happens if I don’t follow the treatment recommendations exactly?

Consistency matters in chronic pain care because the body adapts slowly over time. Not following the treatment plan—such as skipping lab-guided interventions, missing lifestyle adjustments, or not doing prescribed nervous system regulation work—can delay or diminish results. The better the adherence, the greater the chance of meaningful improvement.

Will emotional or psychological factors make the program less effective?

Emotional factors do influence pain, but not because pain is “all in your head.” Stress, trauma, anxiety, and prolonged threat perception change nervous system regulation. Ignoring these contributors can blunt progress. Addressing emotional regulation through appropriate mind-body strategies is neurologically relevant and often necessary for deeper improvement.

Can the program still help if my chronic pain started decades ago?

Yes—length of pain history does not make improvement impossible, but long-standing pain often requires more time, patience, and engagement. Chronic pain becomes embedded at multiple regulatory levels, and unlearning those patterns takes consistent effort. Results may be slower or less dramatic, but measurable gains in pain severity, function, and quality of life are still possible.