There is a ton of misinformation out there about pain, mostly because many of us do not actually understand what pain is and what pain is not. What makes things even worse is that many healthcare providers perpetuate myths about pain or push their patients into an outdated model of pain management.
I am not going to dissect all of the information out there on pain in this article, but rather I am going to go over a few common “myths” about pain and shed some light on the truth.
MYTH #1: NO PAIN, NO GAIN
I hear this one ALL THE TIME! I hear it in the gym, I hear it from clients in the clinic, I hear it from my parents, and I even hear it on TV.
Pain is a sensory output from the brain when the input to the nervous system reaches a certain level, or pain threshold if you will. Pain is meant to alert you when something is wrong or too intense so that you stop doing what you are doing. Not all pain is physical, but that’s a topic for another day.
Pushing yourself to the point of actual pain is counterproductive. Yes, I get it, you need to push into some muscular straining to get a pump and build up lactate and other byproducts of muscle to get stronger. I’m not arguing against pushing yourself to the point of fatigue, soreness, or discomfort. If you are in pain, you should not just keep going. If you are in pain, you are putting too much strain on tissues that cannot handle them.
The idea of “no pain, no gain” will often lead to ignoring injuries until they become debilitating. This means that rather than listening to their body to modify programming, these people will be in pain for a while until the point that they can no longer do normal activities and have to take time off from the activities they enjoy. These people possibly will even need surgery or other treatment.
MYTH #2: I JUST NEED TO TAKE PAINKILLERS FOR MY PAIN
Everyone wants a quick fix. I don’t think that will ever change. With the high value placed on convenience and time, I imagine this will only become more apparent in the coming years.
Painkillers can be effective in managing pain in the short-term. But that is all it does. Painkillers will NOT make you heal faster. Painkillers will NOT fix your problem. They act only as a temporary bandage. The problem is that this “bandage” comes with health risks. Ever hear of the opioid epidemic? That’s what I’m talking about. People get addicted to painkillers and that can have very tragic consequences.
The CDC reports that in 2018, on average 41 people died every day from opioid overdose (including prescription opioids and heroin).
Painkillers are not a long-term solution. They have a place in the medical world, don’t get me wrong, but they are not as effective as lifestyle changes, physical activity, and pain education in long-term management of pain.
MYTH #3: PAIN IS EQUAL TO TISSUE DAMAGE
There are several mindsets around this topic, but most healthcare professionals will agree that pain is not equal to tissue damage. We did not always acknowledge this in healthcare. It sounds like pain and tissue damage go hand-in-hand, but that is not always true.
Many studies looking at pain and findings on imaging studies (X-rays, MRIs, etc.) show that there is no correlation between the two.
To nail this point home, I’m going to give examples from the extremes of each side. Think about phantom limb pain. There is no tissue there to be damaged, yet the pain is very much real. Now think about if you are walking across a street, fall, and break your ankle. Sounds like it would hurt, right? Are you able to keep walking? What if a truck is coming at you full force and doesn’t see you? I bet you’ll get off that street in a hurry and the pain in your ankle will be non-existent until you are clear from danger.
I know those are extreme examples, but they highlight how pain is relative and can be changed by more than just tissue damage/quality.
Thank you for joining me for this myth buster session. I hope this information was helpful. If you have any specific questions about pain you are dealing with, contact us to get some answers.
Corey Hall, PT, DPT