The Reason We Are In Pain & What We Can Do About It
by onsite, March 25, 2017
We live in polarizing times but if there’s one thing we can all agree on, it’s that we’ve encountered numerous painful experiences during our lives. From breaking my nose by running into a pool table when I was a toddler, watching Jose Mesa blow the lead in the bottom of the 9th inning in game 7 of the 1997 world series, to paying my student loans on the 15th of every month. Pain is as much of an emotional state as it is a signal transmitted throughout the body from our skin, muscles, joints, and organs.
For the purposes of this article, we’ll focus on the pain that’s generated from our musculoskeletal system. Pain is critical to our well being and survival. Without pain we would’ve never learned to take our hand off of the hot pan, to stop instigating our older siblings, or when to rest an injured body part.
In the simplest sense, pain is an alert system that can be triggered from our external environment or problems within the body. As the alarm system is set off in brain, we are now poised to take action. Sometimes the painful stimulus requires a simple action like taking your hand off the hot pan or by assuming a better body position. During more serious injuries, prolonged activity modification or several weeks/months of rehabilitation is necessary. This gives the individual time to correct a movement compensation or dysfunctional activity causing the pain stimulus. Typically, the more times the pain stimulus has been triggered, the more sensitive the nervous system gets. If a dysfunctional movement or posture continues, the threshold for the brain sending the pain stimulus decreases, resulting in less tissue strain or damaged required for pain perception to occur.
The catalyst for musculoskeletal pain is tissue damage and/or abnormal body movement. Your body has remarkable healing properties, think of all of the times that you were injured and felt better quickly without any treatment. If every person in the midst of a pain episode sought a professional, there would be an infinite shortage of physical therapists, chiropractors, massage therapists and witch doctors. As remarkable as our bodies are, sometimes our ability to self heal falls short and pain persists.
So how are you supposed to know when you can rely on your body for healing or when it is time for an active approach? First, answer the following questions.
1. Has the pain lasted longer than 4 weeks with minimal to no signs of improvement?
2. Have you experienced several episodes of pain in the same region of the body over the last year?
3. Are you limited in your ability to participate in leisure activities or ability to perform tasks at work due to pain?
If you answered yes to any of the above questions it’s time to address the issue. At a certain point you wouldn’t keep driving with your check engine light on just hoping that it will spontaneously disappear, and the same should be true for your pain. By neglecting your body’s alarm, you may potentially be at greater risk for further tissue damage, developing a chronic pain syndrome, and adversely affecting your mood and/or quality of life.
Once you’ve identified that pain is a problem requiring action, you can start assisting your body in the process. A functional movement assessment from a physical therapist will allow you to learn where you’re movement deficits or limitations are occurring and how to best improve them. We see patients on a weekly basis who are amazed at the results that consistent and direct self-treatment can produce with a little bit of guidance (i.e foam rolling, stretching, mobilizations, strengthening, self myofascial release, etc). Don’t guess what is wrong or watch a video online giving a generalized, cookie cutter exercise recommendation that doesn’t meet your bodies specific issues. Every case of pain or tissue injury is unique, and the combination of factors leading to pain can be very complex. There is no one-size fixes all exercise for reducing back pain, shoulder impingement, or any injury!
I can read every cookbook and follow every one of Michael Simon’s recipes but that doesn’t mean the food will taste as good. That’s why we have professionals in various fields; people who dedicate their life’s work to a certain area of expertise. Physical therapists are expertly trained doctoral level professionals who know human movement better than anyone (yes even orthopedic surgeons or rocket scientists). At some point, to decrease pain patients must begin moving more effectively. Although medications, injections, or surgery may be necessary at times – using these interventions to masque pain without fixing or improving the movement issues can be dangerous in the long run. Like most things in life, fixing movement problems or postural abnormalities that have been developed over years takes some work. It’s not going to happen overnight, but relying on a medication or injection to be a “quick fix” every time we have a pain flare up can cause long term damage to vital organs and connective tissue throughout our bodies.
To conclude, be respectful of your pain not threatened by it. Pain works to alert us to stimuli that require greater attention for the good of our health. And lastly, be positive about your pain. Only an active approach will help to silence your pain alarm system, worrying and negative thoughts will only provoke it. So if you are living with pain, you must ask yourself, what are YOU doing to actively address it? Or are you relying on someone else to constantly prescribe something or “Fix” your pain for you.
The Pain Pal
Scott Robertson, DPT