Not long ago, I worked with a patient who told me her neck felt strange. She described it as if there was a lump protruding outward, something sticking out where it shouldn’t be.
When I showed her a photo of her neck, she was surprised—it looked completely normal. The feeling didn’t line up with reality.
This is what researchers call sensorimotor incongruence: when what the body is doing and what the brain is sensing don’t quite match up. It helps explain why people with chronic pain sometimes describe sensations that sound unusual—like distortion, heaviness, or something being “out of place.”
So what can we do about it? One approach being studied is imagery and movement retraining. Imagery means rehearsing a movement in your mind without actually moving. Brain scans show that imagining movement can activate many of the same networks as doing the movement for real.
Movement retraining takes that idea into practice. It’s about working through movements step by step, with close attention to how the body feels, until confidence and control start to return.
The research so far is promising. For example, in shoulder pain, adding imagery to physiotherapy helped patients recover faster. In chronic low back pain, structured sensorimotor retraining produced greater improvements than sham treatment, though the effects were modest. Other studies suggest that part of the benefit comes from shifting beliefs and expectations—helping people feel safer and more in control again.
But I want to be clear: these aren’t cure-alls. More research is needed, and results vary. Not every patient improves. Still, for some people, imagery and movement retraining can be useful tools.
For my patient, even the simple act of seeing her neck in a photo—and realizing it wasn’t protruding—helped calm her fear and gave her confidence to move again. Sometimes, these small steps can lighten the load pain puts on life.
1. Daenen L, Nijs J, Roussel N, Wouters K, Cras P. (2012). Altered perception of distorted visual feedback occurs soon after whiplash injury: an experimental study of central nervous system processing. Pain Physician, 15(5), 405-413.
PubMed: https://pubmed.ncbi.nlm.nih.gov/22996852/
2. Moseley GL. (2004). Why do people with complex regional pain syndrome take longer to recognize their affected hand? Neurology, 62(12), 2182-2186.
DOI: 10.1212/01.WNL.0000130156.05828.43
PubMed: https://pubmed.ncbi.nlm.nih.gov/15210879/
3. Sırlan S, Alaca N, Yarar HA, Başcı O, et al. (2025). Graded motor imagery as an adjunct to comprehensive physiotherapy in chronic rotator cuff-related pain: a single-blind randomized controlled trial. BMC Musculoskeletal Disorders, 26(1):588.
DOI: 10.1186/s12891-025-08783-w
Full text: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-025-08783-w
4. Cashin AG, Lee H, Wand BM, Bagg MK, O’Hagan ET, Rizzo RRN, Stanton TR, Moseley GL, McAuley JH. (2023). Mechanisms of education and graded sensorimotor retraining in people with chronic low back pain: a mediation analysis. Pain, 164(12), 2792-2800.