Pain is something we all relate to because it’s something that we all deal with. But pain is not something we should ever normalize. Pain is a warning; its textbook definition is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” An important distinction is pain is subjective, we’ll come back to that later on. Being tough, having a high pain tolerance and just walking it off may be valid strategies or descriptors here and there, but again, BEING IN PAIN IS NOT SOMETHING TO NORMALIZE!
Physical pain, which is what I’ll be focusing on arises from two primary sources: suboptimal movement and improper tissue loading. If you do the wrong thing enough times, even if it is small and eventually it will cause a problem, in this case pain. Improper tissue loading takes two forms, one more obvious than the other. If you do too much or something too fast you can exceed what the tissue is capable of handling and strain, sprain, break or tear something. Alternatively, your ligaments, tendons, and bones all require minimal levels of stress/ strain to do their jobs appropriately.
Avoiding the things that cause pain is always the best solution, but it’s not a practical solution to expect. The body will respond to the pain with one or more of several different strategies. Altered movement strategies, bracing the arm, limping, hunching over the grocery cart at the store, etc all serve to protect the body in one way or another. The tradeoff here is protection strategies preserve one area but can create failure points up or down the line.
There are 4 prevailing schools of thought on how pain is processed. Each is valid, and for many some combination of them may be the answer. Th first is that pain exists in a viscous cycle (VC). Basically, pain causes spasm, which reduces the blood flow to the area. This causes metabolites (waste products to build up which sets off a pain and inflammation cycle. The sustained inflammation sensitizes the muscle spindles thus increasing its stiffness, and this is the cascade that results in painful trigger points.
The second theory is Strength Inhibition (SI) and is the most straightforward. When you’re in pain your nervous system limits your maximum force generation in the area. The third is Pain Adaptation (PA), another easy-to-understand theory. When an area or certain movement is painful the neurons in the spinal cord decrease activity in that area and increase activity in the antagonist/opposite muscle groups.
The fourth and most holistic theory is the Protection Response (PR) theory. Injury, or even the threat of pain/injury causes a wide range of motor behavior changes, including everything from redistribution of activity to movement avoidance. This includes concepts such as maintaining force output by cycling through motor units. Reflexes are monitored as they can attune to pain, and biopsychosocial inferences are taken into consideration as they affect the neuromuscular response on multiple levels.
There was a lot of info shared here, and it’s only the slightest scratch on the surface of a very deep concept. But pain, though something we all experience, is not a simple thing. What is a little pain now could fire up the VC of inflammation, one little trigger point can pull on the tissue around it and grow in size and intensity. Straining your shoulder and keeping it hiked up might be reducing how much you can/will use the ROM at your neck. This constricted ROM could cause cervicogenic headaches.
Remember PAIN IS NOT NORMAL! Even if it’s little getting a professional screening and assessment could avoid a world of hurt/impairment. Come visit us at Invoke Therapy and Wellness, we recognize that your pain is unique to you; and we will consider all possible paths from cause to cure to reach the best possible outcomes.
