The Purpose of Pain – how it relates to mechanical damage and what we can learn
Guest Blog by Gavin Routledge, Osteopath and Clinic Director of Active-X Backs
(Please note that in this article, purpose of pain, I’m referring to what we might term “physiological” or “healthy” pain. Some people have pain which is unhelpful such as that related to cancer, or due to an inflammatory disease like Rheumatoid Arthritis.)
Following on from Maureen’s post on hurting her back it got me thinking again about the purpose of pain… What can we learn from Maureen’s painful experience?
By her own description, Maureen felt that she’d “just pushed it too much in a particular movement”. But for many of us, we experience back pain on easy, innocuous movements like putting the shopping in the boot, or drying a foot on the edge of the bath – this is what I call the “Trigger”. What happens within our bodies (and brains) to cause pain, whether it be pushing a yoga move, or drying a foot?
Well, it turns out that there’s generally very poor correlation between the amount of pain we experience and what can be seen on an MRI or X-Ray; you can have someone doubled over in pain, with nothing visible on the MRI, and the next person complaining of an annoying ache, but the MRI shows a large disc prolapse. If you’re interested in reading more, I’ve written about this many times before.
Here’s a table showing lower back MRI findings in people with no pain.
So, rather than looking to the anatomy for a clue, let’s look at something a bit more accessible.
Try this… Grab a hold of your right forefinger with your left hand; bend it back at the knuckle joint, right back until it hurts (don’t push it beyond this initial pain – I don’t think my professional indemnity insurance covers me for you injuring yourself under my direct incitement!). Now let go. Did you reach a point of pain? How does it feel now? Does it still work? Great, you still have 10 working fingers/thumbs.
Next, consider a less common phenomenon – Phantom Limb Pain. This is where someone who has had an amputation (surgical or traumatic), goes on to experience pain in a part of the limb which no longer exists. Weird, but all too common. This is because pain isn’t generated by your body at all (although the process may start there). Pain is always generated by the brain and projected into a body-part – I have a saying “no brain, no pain”. It may sound obvious that you can’t have pain without a brain, but it serves to remind you of the importance of your brain in your pain experiences. It’s not all about what’s happening “out there” in your body, as evidenced by Phantom Limb Pain.
So, your finger hurt, but you didn’t damage it; people with Phantom Limb Pain have pain but no damage (no limb); and lots of people have low back damage (on MRI) but no pain. So, if pain is so poorly correlated with damage, what is its true purpose? The clue is in Maureen’s blog post (and your own finger-bending). What made her pain worse? Sitting at the laptop, which mechanically-speaking put a similar load on her lower back to bending (the original inciting movement). What made it better? Mindfulness meditation and gentle movement – which has a calming effect. If you’d persisted in pushing your finger back, you would certainly have damaged it at some point.
The purpose of pain is to act as an alarm system;
to warn you that if you keep doing that (whatever pain-inducing thing that may be), you’re going to get yourself into a whole heap of trouble. Listen to your pain. Stop doing things that make it worse, or find better ways of moving/sitting/standing such that it isn’t sore. Once you’ve improved your body’s efficiency of functioning (I guess that’s why Maureen called what she does “Complete Movement”), then you can gradually re-introduce more efficient, non-painful ways of doing those activities, once the alarm system has settled down.
It’s likely that Maureen strained a “soft-tissue”, and the pain served to warn her not to do certain activities which would aggravate the injury and slow up her rate of healing. However, it’s possible that she has an old injury there too, which her nervous system was warning her not to push, and that in this instance she didn’t do any real damage (just like your finger). I don’t know. But I do know that you should listen to pain and work with it to uncover the habits which are bad for you.