Chronic postsurgical pain affects millions of patients worldwide and remains one of the most common long-term complications of surgery. While interventions that reduce perioperative pain signalling can lower the risk of persistent pain, substantial variation exists in individual responses to these preventive approaches. Understanding the mechanisms underlying this heterogeneity is essential for developing precision prevention strategies. In this talk, I will present evidence that peak alpha frequency (PAF), a reproducible and scalable EEG measure, indexes vulnerability to pain chronification. Slower PAF is consistently observed in chronic pain populations and emerging findings suggest it reflects susceptibility to pain-related neural adaptations. I will discuss recent work examining how this neural vulnerability may interact with inflammatory processes, proposing that PAF captures a broader neuroimmune state that predisposes individuals to chronic pain. Together, these findings highlight the potential of EEG-derived signatures to identify at-risk patients and guide personalised approaches to preventing chronic postsurgical pain