Pain does not always mean there's injury.
Injury does not always mean there's pain.
In fact, the traditional “injury model” that backache is caused by injury is being questioned now.
With this 'injury model', I sometimes hear words to the effect of: our backs are weak, need protecting, and that small movements can cause injury, when actually our spine is strong AF. It was made to move and bend it all sorts of ways and carry a lot of load.
For example, sometimes we experience injury and/or pain when we our backs have been too strong for too long (and this may be your physical back, but it might also be mentally and emotionally also). Your back sometimes picks up the slack from other muscles such as core, glutes, obliques, hamstrings etc - it was doing all the work. Brushing your hair didn't cause the injury. It was simply (excuse the pun) the straw that broke the camel's back.
Even then, whether there is injury or not, pain becomes a complex phenomenon to explore.
I can't do justice to it, or the full body of research, in this post, but I can at least point out some main feature.
Pain is more than just a physical sensation; it's a complex interplay of biological, psychological, and social factors. When we experience pain, particularly in areas as crucial as our spine, it's important to recognize that our experience is shaped not just by structural or physical factors but also by our emotions, thoughts, and social environment.
For example, often as we approach our third, fourth, fifth and sixth decade of our lives, it is common to find herniated discs, and other physical changes in our spine. This is not always linked to our experience of pain.
For example, in a study comparing patients with symptomatic disc herniation and asymptomatic (no pain) volunteers matched for work-related risk factors, disc herniation was found in 76% of asymptomatic volunteers. There are reports that healthy subjects with disc extrusion on MRI have no backache, nor sciatic pain in 5 or 7 years.
Meaning: you can have a herniated disc, and no pain whatsoever.
(Conversely, you can have no physical injury, and experience pain - although this does not at all mean 'it's all in your head', your experience of pain is very real because it is a sensation that is created by your brain for a reason).
Pain can be significantly influenced by our thoughts and emotions. Stress, anxiety, and past experiences with pain can amplify our current sensations. When we carry worries about our injury, it can lead to a cycle where we become more sensitive to pain. This phenomenon is known as central sensitization, where the nervous system becomes overly reactive to stimuli.
Again, this does not mean that pain is all in your head (no more of that gas lighting please).
You are experiencing pain - often for a reason.
Your body and brain are often trying to communicate something.
Many, many factors contribute to our experience of pain, and we cannot underestimate the role of our individual and social environment. This includes relationships, community support, education access, past experience of trauma, disadvantage and discrimination, and societal attitudes toward pain and injury.
Consider the whole, not just the symptoms.
Finally, a word on movement, as it relates to our experience of pain and injury: pain and/or injury doesn't automatically mean no movement is the best option (and I'd suggest in many cases, could be one of the worst options). More often than not, there is some movement that is possible at some point in our experience of pain and injury (when and how much, of course, remain individual questions).
Adopting a movement mindset can help redefine our relationship with pain. Rather than viewing it as an enemy to be avoided, we can see it as a signal to engage with our bodies more compassionately. Recognizing that movement, even in small doses, can be beneficial in our healing journey, allows us to reclaim our physical autonomy.
And that, in and of itself, can change a lot.
To me, oftentimes this model might raise more questions than in answers right now. But it also opens the door to other conversations, and other ways of relating to injury and/or pain.
It invites a bigger picture, more compassionate mentality.
And as you know (or are hopefully getting to know), this is a favourite approach of main.
What are your experiences and reflections on your experiences of pain?
Want to move and you have pain and/or injury? Our small group personal training is a supportive, compassionate place to start - try us here.
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