Does Pain Always Mean Something is Damaged?

Have you ever woken up with a stiff neck after sleeping in an awkward position or felt muscle soreness for a couple of days after attempting a new workout? In both situations, you have likely experienced pain without having suffered from a serious injury.

What is pain and why does it happen?

Pain is part of the body’s protective alarm system. Your brain continuously processes

information from your body and environment and may produce pain when it perceives a

potential threat. This protective response can help us avoid further irritation or injury, but the intensity felt does not always reflect the amount of tissue damage present (1).

How has our understanding of pain changed?

Traditional View: Pain was traditionally viewed as having a direct relationship with tissue

damage, with greater injury expected to result in greater pain.

Modern View: Pain is more of a complex and highly personal experience influenced by

biological, psychological, and social factors, rather than just being a measure of tissue damage. (1)

Factors that influence your pain experience: previous history of injuries, stress levels, quality of sleep, emotions, and the environment around you.

This helps explain why signals from the body do not always result in pain, particularly when we feel safe or are engaged in meaningful activities. It can also help explain why pain can seem to persist or flare up long after after the expected time for tissue healing, especially during periods of poor sleep, increased stress, fear, or emotional strain.

What does this mean for recovery?

Based on the more modern approach, this means that as therapists we need to treat the whole person instead of just the damaged tissue area. By combining education with individualized exercise, we can help clients build confidence, reduce fear of movement, and help them safely return to participating in activities that they enjoy. (2,3)

Bottom Line: Pain is a very real, personal, and complex experience, but it does not always mean that damage is occurring. Developing a better understanding of how pain works can be an important first step toward moving with greater confidence and recovering more effectively.

Disclaimer: This information is intended for educational purposes only and should not replace individualized medical advice. If you are experiencing new, severe, persistent, or concerning pain, consider consulting a qualified healthcare professional for appropriate evaluation and guidance.

References

1. Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., Keefe, F. J., Mogil, J.S., Ringkamp, M., Sluka, K. A., Song, X. J., Stevens, B., Sullivan, M. D., Tutelman, P. R.,

Ushida, T., & Vader, K. (2020). The revised International Association for the Study of Pain

definition of pain: Concepts, challenges, and compromises. Pain, 161(9), 1976–1982.

2. Watson, J. A., Ryan, C. G., Cooper, L., Ellington, D., Whittle, R., Lavender, M., Dixon, J.,

Atkinson, G., Cooper, K., & Martin, D. J. (2019). Pain neuroscience education for adults with chronic musculoskeletal pain: A mixed-methods systematic review and meta-analysis. The Journal of Pain, 20(10), 1140.e1–1140.e22. 

3. Bülow, K., Lindberg, K., Vaegter, H. B., & Juhl, C. B. (2021). Effectiveness of pain

neurophysiology education on musculoskeletal pain: A systematic review and meta-analysis.

Pain Medicine, 22(4), 891–904.