Pain is incredibly complex…

…In fact, it is so complex that the brightest and most learned minds of modern science have only scraped the surface in understanding the precise causes of pain, why some people experience it more than others, and how we can intervene to manage and “fix” pain. Pain research has come a long way and is gaining traction in the scientific community and we are certainly making leaps in our understanding. But I think it is very important to recognize how much we still don’t know and how complex of an issue pain is for many individuals. 

I spend a lot of time thinking about pain because, well, I have lots of it. For almost 7 years I have been dealing with chronic headaches, fatigue, and neck pain. And for over 2 years I have had persistent SI joint pain that radiates symptoms into nearby structures (low back, pelvic floor, deep butt). And as much as my experience with pain has been (and continues to be) frustrating, discouraging, and often debilitating, it has also given me an immense appreciation and intimate understanding about how complicated pain is and how little we know about why it arises and what we can do to help. 

I think it is easy to fall into a trap, especially in the online world of movement education, to get the idea that pain can be easily remedied. All you have to do is this type of strength work, or that type of myofascial release, or see this specialist, or take that medication… And in some cases, pain certainly is easily remedied. But this is not always the case and we need to make space for people who’s experience with pain is not so straightforward. 

For some people, pain is a moving target. It can manifest ever changing sensations. It can migrate to structures near and far its epicenter. People who lead exceptionally healthy lives – they move often and in varying ways, they strength train, they eat well, they sleep, they take care of their mental health, etc – deal with pain. I have noticed a trend in the movement education world, particularly in the “modern yoga” realm, to talk about strength training as if it’s that ONE thing that will remedy persistent aches and pains and stave off all that is painful in the bodily world. As a movement educator myself (and soon to be a PT), I absolutely believe in the power of strength training and a movement rich lifestyle. AND I also believe that when it comes to pain, for many individuals, it may not be enough. 

I don’t write these words to be discouraging. Rather, I hope to remind us that pain is complex. Pain is also “all in your head”. And I don’t mean that in the way it might be interpreted. I mean it in that pain is a neural output – it is a signal created by the brain. And while we might not always know why the brain creates pain signals that persist, we do know that reasons are vastly multifactorial. We know that pain should be managed using a bio-psycho-social approach. In other words, we know that our psychology, our environment, and our biology all play into our experience with pain and should therefore all be addressed when managing pain. 

I hope that this perspective helps inform movement educators that what we offer is absolutely valid AND helpful AND great AND… sometimes… it is not enough. In one sense, I am lucky to be unlucky. That is, I believe that my experience with pain and chronic illness will challenge me to be a better clinician for my patients when I become a PT. I feel a drive to learn as much as I can about pain, what we CAN do to help, while continuing to be honest about our limitations and recognizing how much we still don’t know. 

 

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