Pain is a simple sensation, right? You bump your knee and it hurts. It will probably hurt until it’s
healed. Is that all that’s going on? Not quite. Pain can persist (chronic pain), move to other parts of the body (radiating/referred pain), or even manifest in parts of the body that no longer exist (phantom limb pain). In the physical therapy world, we go even further as to classify pain as nociceptive, neurogenic, or central in origin. The study of pain and its various manifestations within the body is termed ‘pain science’.
The Science of Pain and Recent Discoveries
‘Pain science’ is a popular topic in the health realm. As is the association between pain, fear,
and disability. We’ve made big discoveries in the relationship between the brain and pain. The
introduction of brain scans opened our eyes to the hormonal contribution to pain,
neuroplasticity, and central/peripheral sensitization. Even more recently, brain scans of those
dealing with prolonged pain revealed changes in gray matter in the brain, especially in the
prefrontal cortex. These structural alterations are linked in research to increased rumination
over pain and decreased ability to cope with pain. Researchers believe that these structural
changes decrease the brain’s ability to activate pain inhibition pathways within the nervous
Pain, especially chronic pain (lasting more than 3 months), affects many people. It can lead to
missed work and antisocial behaviors. Not only is it stressful on our pockets, but it’s stressful
mentally. Many people are quick to ‘catatrophize’ pain and all of the events surrounding their
pain, particularly when pain becomes chronic. This can lead to depression and
avoidance of physical activities that they associate with their pain. Later down the line, this can
cause muscle deconditioning and a cycle of pain recurrence because the tissues aren’t getting
appropriate, graded stress necessary for the healing process.
How to Approach Pain
As you can now tell, pain is much more complex that we once assumed. Reframing pain to be
less threatening can better serve our bodies and minds. It is important to first understand that
pain does not equate to tissue damage. Increases in pain do not necessarily mean you’re
tissues are being damaged more. Movement is necessary and your physical therapist is a
movement expert who can help you move more efficiently. Don’t forget that movement produces
endorphins - our body’s natural pain-killers! Understanding the negative repercussions of
movement avoidance and interrupting the cycle of unhealthy emotional responses to pain can
have a profound effect on your overall wellbeing. It is empowering to know that you have control of your pain. This will ultimately assist in putting an end to the pain cycle.
Consult with your physical therapist to gain more insight into your pain and create an action plan to address it. You will learn ways to move without increasing pain, thus combating movement avoidance. In physical therapy, your therapist will help you set specific goals in relation to physical health. Goal setting is an important step in creating your own success.
Other methods to combat pain include mindfulness and breathing techniques. These techniques help promote relaxation and easy pain-related anxiety. Yoga and Pilates are excellent movement practices that promote mind-body connection through controlled poses and specific breathing techniques. If you’re into Chinese medicine, acupuncture is another great option for pain reduction. These strategies will help you take control of your pain and allow you to return to meaningful life activities.
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