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Northwest Physiotherapy Group

It may surprise you to read that the common understanding of how pain arises has recently been shown to be inaccurate.

Is this why pain and injuries are a huge challenge for so many people?

This information is presented with the intention that you will develop a more accurate and simple understanding of pain.

 

The Number One Misunderstanding About Pain

Is that pain always comes from injured tissues at the site where pain is felt and that pain signals are sent to the brain from the tissues and structures within the body.

There is a growing body of neuroscience and physiotherapy research that is making it very clear that this is not the case. This research has shown that there are no 'pain receptors' or 'pain signals' from the tissues. (Butler and Moseley, 2015)

This insight is very helpful to directing our attention to the factors within the body that need to be fixed to get rid of pain.

What Does The Latest Research Explain?

Pain is actually created by the brain - for good reasons.

Pain is a warning signal created by the brain to help protect the body and prevent further damage.

Imagine the scenario of a car that is malfunctioning with a bright engine warning light on the dash.

Is it sensible to think that we can fix the problem by doing something to the warning light?

Or would it be more sensible to acknowledge the warning light and then check out every possible structure that could be causing a problem to the car’s engine?

Recent studies teach us that pain is the brain's equivalent of a dashboard warning light. (Sueki et al, 2103)  This way of thinking appears to be the simplest and most accurate way to understand pain.

So pain is created by the brain and can be experienced in any part of the body.  For example, an injury occurs in the spine and the warning signal produced by the brain creates a pain-experience 'in' a limb. In this way limping, or walking differently, is a protective mechanism to reduce strain to the spine - because the leg hurts.

  • Seeing conditions this way ensures that we treat the body parts that need the most help and not just where the pain is created.
  • It also helps us identify certain movements or postures that may be increasing strain to the injured body part, allowing us to modify and retrain movement to improve recovery.  

It is important to note that this way of thinking does not lessen the significance of pain. On the contrary, it actually validates how important pain is as a warning signal. Pain is a very important indicator for us to pay attention to and change what we are doing to protect us from harm.

  • Understanding that pain is created by the brain allows us to focus on fixing the parts of the body that are the underlying cause of our brains creating the pain.
  • This sometimes means that treating areas different to where the pain is experienced is the best way for most rapid and long-lasting results.

For example, if someone's right arm uses a mouse most of the day in an excessive forward-shoulder position and this creates a gradual build up of tension in the mid-back, in some people the response by the brain is to create the experience of pain like it is 'in' the right arm. Often this is also accompanied by muscles, nerves and joints becoming tight and sore in the right arm, which may be diagnosed as Repetitive Strain Injury. When the main cause - the mid back - is identified with good physiotherapy assessment, and effectively treated, this results in rapid resolution of the right arm pain. 

 

  • Then changing the mousing position, or posture, to minimise mid-back strain results in the brain having no reason to create the right arm pain again.

This is a good example of why pain and symptoms are not good indicators for figuring out how to solve a dysfunction. In the example above, treatments to the pain in the right arm would not solve the problem, or gain a rapid and long-lasting result.

So how does this new understanding of pain help solve pain faster?

Let’s go back to the example of the faulty car and the dashboard warning light.

How good would it be for all the parts of the car to be tested to see which ones are faulty?

How good would it be to fix the faulty part, and know how to check this for yourself at regular intervals in the future?

What might happen to the dashboard warning light if you took this approach?

Clearly, this would result in the warning light going off and staying off. Plus, this would result in an optimal performance of the car.

This analogy fits the human body. How good would it be if your warning signal, i.e. pain, alerted you to get every part of your body tested that could relate to your problem to find out which ones might be faulty?

 

The next step is clear – we need to find and fix the most significant dysfunction contributing to your condition.  If we can achieve this, the warning signal of pain is no longer required to be ON. The bonus is that the body then functions at its highest performance.

And the next step after that is highly valuable. Self checking your main dysfunctions in the future and ensuring they remain in good shape is the best way of preventing recurrence.

For proactive people, the dysfunction can be “tuned-up” before the warning signal comes on, i.e. before any pain occurs. 

Many people are this proactive with their car, and this proactive with their teeth, and their general health with a GP.  Imagine how much easier, and less expensive in the long run, it would be if we all learned to be this proactive for our musculoskeletal body parts.


At NWPG, this is why we assess the whole musculoskeletal system when a client presents with pain in any particular body part. This thoroughness ensures we evaluate and treat all possible contributing factors to your condition, so that we gain a rapid and long-lasting result. This is a systematic process we take you through carefully to get a total solution to your problem. It includes teaching you how to self-check and manage your main problem areas to prevent recurrence and maintain optimal musculoskeletal health.