Understanding Pain - Common Myths Debunked

Unfortunately, pain is commonly misunderstood. So, let's clear up the most common myths and misconceptions I hear about treating people's pain.

Myth 1: Pain means damage is occurring

Classic models of pain view it as a 1-1 relationship with damage in the body. If you cut yourself, the level of pain will correspond with how much damage there is. Breaking my femur will hurt more than stubbing my toe.

This is the biomedical model of pain. It assumes that symptoms are the result of tissue pathology and that there should be an organic solution for all symptoms. At this point, the biomedical model is considered reductionist in that, according to it, all pain is a simple signal of tissue injury.

It makes logical sense to stop here until you reflect on your own experience of pain. When I accidentally bang my elbow on the end of something, why do I start rubbing my elbow to help relieve the pain? And why does this work? Does my other hand have magical healing properties?’ Why do I sometimes feel pain while doing nothing to trigger it?

We now realize that pain isn't solely related to what's structurally going on. This has been illuminated by situations like diabetes and depression that intensify feelings of pain with no physical or structural changes or damage seen.

If you've ever gone for an MRI or X-ray to see why you're in pain, only for it to come up squeaky clean, this is why. As frustrating as it can be, we can't always "see" pain physically.

Our perceptions of our pain, for example, can change how we feel. If we expect to be in pain or catastrophize our pain, it can make our experience with it worse. This is all described as the biopsychosocial model of pain, showing how many factors go into why we may be in pain.

The biopsychosocial model of pain

Myth 2: Bed rest will fix your pain

I was told when I was diagnosed with a disc herniation all the things I should no longer do. Don’t lift weights (definitely don’t deadlift), don’t let your spine round forward, the list goes on. The main recommendation was to rest and give my spine a chance to heal.

If you run and feel knee pain, a health practitioner will simply tell you to stop running.

This makes logical sense at first. An irritated, injured tissue needs a chance to recover, and constantly loading it further may make the issue worse. We also want to limit inflammation, allegedly.

But absolute rest starts a negative feedback loop and puts us in what I call “movement jail”.

When we experience pain and injury, we often catastrophize our situation, creating fear and hesitation when it comes to movement.

We begin hyperanalyzing everything, thinking about basic movements that would have been automatic before. Naturally, we begin to move less. Because the body operates on a “if you don’t use it, you lose it”, system, further disuse leads to further inability to move.

This, in turn, leads to a greater experience of pain. It’s not solely based on physical ability, but the psychological factors feed into it too.

Like any fear, it’s best to confront it and, in this case, find ways you can move. It doesn’t mean you go back to exactly what you were doing before or even what hurt you, but the point stands.

Muscles and joints respond well to movement, even when they’re injured. That’s why more recent evidence-based treatment plans involve optimal loading to not only supply circulation to the area to aid in healing, but to avoid this “movement jail”.

Not to mention if your goal is to return to your sport or activity, like running, your plan should involve a return to activity.

Myth 3: Your posture is causing you pain

"Sit up straight", you'll ruin your posture. We've all heard this a million times.

What if I told you there's no such thing as bad posture?

If I sit in the same position, slouched forward, for 8 hours, it's not a good thing. You'll likely feel tight and in pain.

But if I "sit up straight" also for 8 hours, I'll also likely feel tight and in pain.

In other words, it's not the posture that's the problem, it's the fact that we're stuck in the SAME posture for so long.

The best posture is the next posture. Ideally, you change positions every 30 minutes or so to keep your muscles and joints moving.

Myth 4: There are magic exercises and stretches that can cure your pain

"I did these 3 back exercises and my pain disappeared!" How many social media blogs and videos have you seen with eye-grabbing headlines like this?

If 3 magical exercises fixed everyone's back pain, we wouldn't have the back pain epidemic we do now.

Going back to Myth 1, there are tons of factors that can affect pain. Exercise and movement are good, of course, but an exercise or stretch that works for one person's pain may not work for another's, even with the same diagnosis.

For example, back extensions and Jefferson curls felt amazing for me when I was rehabbing my disc herniation. But for some back pain patients I've worked with, those movements aren't tolerable.

In other words, movement is generally good, but you need to find movements that agree with your particular pain to progress properly without irritating the issue.

As you can see, pain is complex and doesn't often have a simple solution. I wish it were as simple as fixing a structural problem or finding the perfect stretch, but that's not reality. Like with any problem, it's important to understand it better to find a long-lasting solution. I hope this was a good first step towards that.

To your good health,

Coach Stephen

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Thanks for reading.

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