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Dave Clarke

@daveclarkemd

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🥼 Founder & MD of @neuroplasticorg
🩺 Transforming treatment of chronic pain & illness with neuroplastic recovery therapy
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I want to share the single most-used exercise in my clinical practice. It costs nothing, takes about an hour, and has started meaningful recovery for thousands of my patients over 40 years. The exercise is a stress inventory. It sounds simple to the point of being trivial. It is not. Step one. Take a blank piece of paper and, across the top, write: things in my life that cause me stress, anger, fear, sadness, or worry. Then list everything you can think of, from the present or the past (even from childhood). Do not censor. Do not judge whether it “should” be on the list. Do not worry about whether other people would consider it significant. If it lives in your nervous system, put it on the page. Step two. Carry the list with you for a week and add anything new that comes to mind, whenever it comes. You will be surprised how much rises to the surface once you have given it a place to go. Step three. When the list is reasonably complete, rank the items in order of the weight they carry. This is often illuminating on its own. Patients discover that the thing they thought was the biggest stress is not, and that quieter things they had been dismissing have been generating more physiological load than they realized. Step four. Choose the top two or three items you can actually change. Not the ones you should. The ones you can. Then begin, one at a time. What often happens next is that the physical symptoms begin to shift, sometimes within weeks. Not because the exercise is magic, but because addressing real sources of stress you have been carrying is one of the most direct ways to reduce the load on a nervous system that has been running on high alert for years. by @daveclarkemd
298
a month ago
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Your body knows who is safe and who isn’t. by @daveclarkemd
22
4 months ago
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This is one of the most important carousels I’ve made. Women with chronic pain are systematically undertreated, underdiagnosed, and dismissed. The data is overwhelming and infuriating. Women wait longer for pain treatment. They’re more likely to be given anti-anxiety medication instead of pain relief. They’re more likely to hear “it’s stress” or “it’s emotional.” And conditions that predominantly (or solely) affect women, like fibromyalgia, endometriosis, and chronic pelvic pain, receive a fraction of the research funding of comparable conditions. In my 25 years of practice, I saw this bias firsthand. Women with severe, debilitating symptoms were told by previous doctors that nothing was wrong. They’d been to 5, 10, sometimes 15 specialists. All dismissed. And when we finally explored the connection between their life experiences, their stress history, and their nervous system, answers emerged. Not because the pain was imaginary. Because the real cause had never been investigated. Neuroplastic pain is real. It’s treatable. And women deserve to know it exists before they spend another decade being told to “manage their stress.” Share this with a woman who needs to hear it. 🔗: symptomatic.me by @daveclarkemd
1k
6 months ago
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From chronic illness to recovery, to practitioner. I haven’t shared my full story of how I arrived at this work, but Im proud to give back and serve the chronic symptom population. I’m so glad to have had the opportunity to attend the 2026 ATNS @neuroplasticorg Conference. It was the icing on the cake to my neuroplastic journey. ♥️ 🧠 #unlearnthesymptom #chronicpain #nervoussystemregulation #texastelehealth by @daveclarkemd
0
2 days ago
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Maybe your X-Ray or MRI showed abnormalities, but that might not be why you’re in pain. by @daveclarkemd
4
3 days ago
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Here is a diagnostic clue I would like every chronic pain patient to carry into their next clinical conversation. Symptoms that follow a specific schedule, direction, or location are almost never structural. A patient came to me years ago, a middle-aged man with severe chronic symptoms that had eluded diagnosis after extensive workups. When I asked about the pattern, something specific emerged. He had symptoms exclusively during his morning commute to work. Not on the drive home, not on weekends, just the drive to work, five days a week. Once he described the pattern, the diagnosis was essentially made. Structural conditions do not know which direction you are driving. If a disc is damaged, the disc does not care whether you are heading toward the office or away from it. If 30 minutes of driving on Monday morning aggravates a structural problem, so should 30 minutes on Monday evening. His did not. What does know the direction you are driving is your nervous system. His body was speaking clearly. He hated his job. He had known it consciously for years and had pushed it down because he could not see how to leave. His nervous system, having no way to push anything down, was doing what nervous systems do. It was raising an alarm. His recovery did not require him to quit that day. It required him to first acknowledge what his body had been signaling for years, and then decide consciously what to do with that information. Some patients change jobs. Some restructure the parts of work that were most punishing. Some reframe what the job means to them. Any of those can work. What does not work is continuing to override the signal. If your symptoms show up on a schedule, follow a specific direction, or appear only around certain people or places, please take that pattern seriously. Your nervous system is naming your triggers. Start at neuroplastic.org. Source: Clarke DD. Neuroplastic Symptoms: Diagnosis and Treatment. (2026). Presented at Oregon Health & Science University. by @daveclarkemd
4
4 days ago
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There are way too many terrible myths about brain-generated neuroplastic symptoms. 🧠 by @daveclarkemd
4
5 days ago
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A recent article in The Economist made a case that every chronic pain patient should sit with. A growing number of patients insist on surgery based on inconclusive tests. Surgeons feel pressure to say yes. Insurance companies cover procedures that clinical trials have shown do not outperform placebo or physical therapy. David Ring, an orthopedic surgeon at the University of Texas at Austin, is quoted plainly. Scan abnormalities in knees, backs, and shoulders are “as natural a by-product of ageing as wrinkles and grey hair,” and they are found just as often in people without pain as in those with it. What patients are being told is causing their symptoms very often is not. The article also captures the incentive structure. In America, some surgeons fear their patients will leave them a bad review online if they decline to operate. Insurance companies cover ineffective procedures rather than risk losing customers to competitors. The article names the problem clearly. What it does not name is the answer. If the abnormality on your scan is not really the cause of your pain, and the surgery to fix it will not really relieve you, what is actually going on in your body? For patients whose pain is not caused by injury or disease, the answer is almost always the same. The pain is neuroplastic. It is generated and maintained by a nervous system that has learned a pattern of protective signals. It is real, it is treatable, and it is a condition that most surgeons have never been trained to evaluate for. If your imaging shows something and you have been offered surgery, please ask your surgeon whether your pain has been evaluated for neuroplastic contributions. The fix you are being offered may not be for the condition you actually have. Start at neuroplastic.org. Source: Many Surgical Interventions Are Little Better Than Placebo. (2026). The Economist. by @daveclarkemd
4
6 days ago
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The kid who learned to stay quiet can grow into an adult with chronic pain. by @daveclarkemd
11
7 days ago
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I want to share one of the most reliably effective exercises I have prescribed in 40 years of practice. It costs nothing. It takes an hour. It requires no therapist, no doctor, and no permission from anyone else. And it has helped patients whose chronic symptoms had resisted years of every other kind of treatment. Write a letter to the person from your past who most hurt you. And then never send it. That last part is essential. The letter is not for them. It is for your body. Here is why this works, and why it works quickly for many patients. When someone has hurt us, especially over a long period, and especially when we were children, our nervous system holds an enormous amount of unspoken content. Anger we were not allowed to voice. Fear we could not name. Grief we could not afford to feel. Boundaries we could not enforce. Words we could not say without consequences. These do not disappear. They live in the body. For many patients I have seen, they are one of the largest single drivers of chronic pain or illness that is not caused by injury or disease. The unmailed letter works because it lets the nervous system finally do what it was never allowed to do. Speak. To the person. Fully. Uncensored. At full volume if needed. The nervous system does not know that the letter will not be sent. It only knows that, for the first time, the words are leaving the body and landing somewhere. There are a few practical instructions. Do not water it down. Do not soften. Do not add “but I know they were doing their best” if that is not what you feel. Say the actual thing. Include everything. If it takes multiple letters, write multiple letters. When you finish, decide what to do with it. Some patients burn the letter as a ritual. Some tear it up. Some save it in a locked file. Some read it out loud to themselves. What matters is that the words are no longer inside you unspoken. [cont. in comments] by @daveclarkemd
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10 days ago
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Are you feeling constantly nauseous, but the endoscopy showed nothing? Here’s the hidden cause. 👆🏼 by @daveclarkemd
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11 days ago
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I want to share a case that has stayed with me for years because it illustrates how far a nervous system will go to carry what a person is not allowed to feel. The patient was a 16-year-old Latino gang member. He came to me with several months of severe abdominal pain that no imaging, no lab, and no procedure had been able to explain. He had already seen multiple physicians. He had already seen three mental health clinicians. He had also been told, in various ways, that his pain was serious, mysterious, and possibly permanent. When I took his history, one detail came up that changed everything. His abdominal pain had begun the week after his first visit in six years with his estranged father. He had traveled roughly a thousand miles for that reunion. His father was violent. His father was an alcoholic. The visit did not go well. Now consider the position this young man was in. He was 16. He was a member of a community and an identity structure that had strong expectations about how young men handle their feelings. Rage at his father was, in the most literal sense, not permitted. Not by his culture. Not by his gang. Not by his own sense of who he was supposed to be. There was no safe place for that rage to go. So it went to his body. This is one of the most consistent patterns I have seen across 40 years of practice. When intense emotions have no permitted outlet, the nervous system finds another one. Chronic pain, severe abdominal symptoms, migraines, unexplained fatigue. The mechanism is not mysterious. Emotions are physiological events. If they cannot be experienced or expressed, they still have to go somewhere. Recovery for this patient did not require him to leave his community, adopt a different identity, or resolve his relationship with his father. It required a safe context in which he could name what he actually felt, hear that his rage was legitimate and understandable, and let his body stop being the container for it. [cont. in comments] by @daveclarkemd
7
12 days ago
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