Recently, I spent some hours in a workshop about pain. I had high hopes that I would come away with some spiffy new exercises to wave around and POOF! Pain would vanish from my clients’ bodies and my own.
Sadly, pain does not seem to work that way. There is no magic wand. However, there was some good information.
For one thing, pain is not the same as damage. When we think about it, we know this is true. To use an extreme example, phantom limb pain is a feeling in a body part that no longer exists. Pain does correlate with damage, but even that is not as strong a relationship as we might think. For example, a literature review of studies of people without low back pain and the MRI images of those people found that, depending on the age of the subjects, from 37% to 96% of the people showed degenerative disks in the spine. In other words, more than a third of younger people and nearly all of older people showed tissue damage without pain. Conversely, plenty of people feel lower back pain without observable damage.
So what is pain? Pain is an interpretation made by the brain of data from nociceptors (nerve endings that detect “noxious” sensations) in the body. The sensory data is like a smoke alarm; it is the brain’s job to decide if there’s a fire or if someone is just cooking bacon in the kitchen again.
Please let me be clear: while pain is a function of the brain, it does not mean that pain is all in our heads. We are reacting to real stimuli in the real world.
What we can do about pain is to change our reactions. Sometimes it is as simple as not doing something that hurts. Other times, we need to learn more about what we’re feeling. When we first start to exercise and do a bunch of squats and our thighs start to burn, we might interpret that sensation as pain; later, once we have had the feeling often, we might interpret it as a sign that we’re getting in a good workout. The sensation has not changed, but our interpretation has.
After we have had an injury, the picture can be more complicated. Damage has occurred. But, as we saw above, damage and pain don’t always go together. The longer it has been since we had the injury, the less likely our pain is to be correlated to tissue damage. In other words, if our injury was more than three months ago, the tissues are probably all right (of course, we should check with our doctors for actual diagnosis and treatment!). The pain we feel can come from all kinds of other things, like changes in movement patterns, muscle guarding, and fear of injuring ourselves again. What we need to do in this instance is move. Notice that I did not say we need to move the part that hurts. Moving any part of the body will help reduce pain in the whole body. We need to increase our sense that we are safe in movement (lots of ways to do this, including working with a trainer, taking things slow, making movements small, etc.). And we need to look critically at the sensations we are having—discomfort is not the same as pain—so that we can retrain our brains to be less reactive.
Maybe I wanted a magic wand and got a bunch of tape measures and hammers and screw drivers instead, but tools are better than no tools.
Go play.
