Greetings, Reader!
I woke up on Sunday and found a giant bruise on my right wrist, and two circular bruises, one on the back of each arm. It's been almost a week, and they've barely faded. I have no idea where they came from!
They look pretty gnarly, and you'd think that they would really hurt, but they actually don't hurt at all, even if I press on them.
Pain is a funny thing, and it's quite misunderstood.
We've been taught that if we have pain, there must be some kind of damage. Our medical system is based on this inaccurate biomechanical perspective. When something hurts, we get an X-ray or MRI to figure out what is broken, and we are given a pill, a brace, an exercise, or a surgery to fix the damage.
But I clearly have tissue damage with these bruises, and I don't have any pain. It's not because I have some superhuman ability to not feel pain; it's because pain is not caused by tissue damage.
A great example of this concept is phantom limb pain. According to the Amputee Coalition, 80% of people who have one or more limbs amputated have experienced pain in the part of the limb that is no longer there. In this case, there isn't any tissue in that part of the body, but the pain is no less real.
When I was completing my Therapeutic Pain Specialist certification with Dr. Adriaan Louw at Evidence in Motion, I read study after study that showed that there isn't any correlation between the results of diagnostic imaging and patients' symptoms. You simply cannot see pain on an X-Ray or MRI.
There are tons of people who have structural problems, including rotator cuff injuries, torn menisci, herniated discs, and osteoarthritis, but they don't have any pain. My friend walked around on a torn meniscus for years and had no idea because it didn't hurt at all.
There are also many people who have a lot of pain, but no significant findings on their images. I was one of those people. When I was struggling with chronic pain and I lost my ability to use my right hand, they couldn't find any structural problems on the X-Rays and MRIs I had of my neck, arm, or hand, and yet I had severe pain and functional deficits.
The source of pain isn't in the tissues; it's in the nervous system, and when I finally figured that out, everything changed for me and for my patients.
I know that it can be hard to believe in the context of a medical system that scares us into thinking that pain won't go away unless we fix our bodies, but the biomechanical model of pain is outdated, and clinging to it is actually doing real harm:
- It makes people fear that when they have pain, something is really wrong with them.
- It prevents people from getting the care they need, focusing on treatments that don't actually address the root causes of the pain.
- People whose pain can't be explained by a structural problem get told their pain isn't real, it is all in their head, or that they are exaggerating.
No matter how you slice it, the end result is more fear and more pain. That's a problem because fear causes the nervous system to interpret sensation as dangerous, which in turn causes the nervous system to sound a warning alarm in the form of pain.
Pain = Sensation + Fear
Whatever caused the bruises to form on my arms happened without my knowledge. Since my nervous system didn't detect any threat, I simply didn't feel any pain.
In contrast, I had a similarly gnarly looking bruise that bloomed a few years ago after I dropped a block of wood on my foot. I was so worried I broke my foot, and that bruise hurt a lot.
Now, if you have a broken bone, you've just had surgery, or you have an injury, you do need to intervene so that tissue can heal. But if you really want to work with the pain, you also have to work with the nervous system. And if you don't have any structural damage but you do have pain, repatterning your nervous system will change your life.
If you are in pain, especially if you've already tried all the structurally-focused treatments and they haven't worked, schedule a free consultation. I'd love to help you teach your nervous system to stop producing pain.
In love and solidarity,
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Rachel
Doctor of Physical Therapy & Integrative Pain Specialist
Rewire your nervous system and break the cycles of chronic pain, depletion, burnout, and overwhelm so you can be fully present for what matters most in your life.
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