What if pain isn't the enemy after all?

​If you fear that my next words are going to be something along the lines of "pain is a part of life, get used to it", you can relax your shoulders right now. As a doctor of physical therapy, my goal is to help you experience less pain, not be resigned to it.
What I do want to talk about is not the if (all of us want to have as little pain as possible) but the how to get there.


Pain, as annoying or terrible as it might feel (and I suspect all of you reading this have had a bit more of the whole spectrum of that than you bargained for) is actually not a mistake, nor is it a punishment, nor an enemy. It is a message, a call for our attention. It says: "Hello! Something's wrong and I want you to fix it."


Some people actually lead a life that you may often have longed for, a life without any pain. They have something called Congenital Insensitivity to Pain (CIP, also called congenital analgesia), a genetic disorder in which individuals are unable to perceive physical pain. While this may sound like a blessing, it actually leaves individuals unable to notice damage to their bodies as it occurs, and can lead to significant injuries, and even shorter life spans. Imagine not noticing a sharp rock in your shoe, and instead ending up with a hole in your foot, or burning your hand without noticing!


Pleasure is the way our body tells us to move towards something, that something is good for us, whereas pain tells us that something is wrong, to move away, to change something. It guides us in important ways.  It may not be a pleasant message (in fact, that's how it gets our attention!), but it is one we'd do well to pay attention to, instead of merely trying to suppress it, or ignore it.


Imagine receiving a letter from a dear friend explaining how you -- probably inadvertently -- hurt him/her, a call for you to make amends. If you disregard and delete the message because it's painful to read, you are probably also deleting the friendship. In a similar manner, the message from the body telling you that something's gone wrong can be very painful to feel, but it's equally important to heed. Tuning out of the body's pain -- dissociating from it -- may be a natural desire, but not a wise long term choice. Pain medications can be a blessing, but rarely on their own.




Your body is not the bad guy 


When we've felt pain for a long time, it's easy to start to see the ailing body part as the enemy. Our language reflects this. "I have a bad back", "this is my bad knee", "that darned shoulder is hurting so much!". But your back, knee, shoulder, or whole body, for that matter, is actually not the perpetrator. It didn't hurt itself, it was hurt. It doesn't want to hurt, it's asking for help. If you can shift your mindset to feeling compassion for the ailing body part, you've taken a big step in the right direction. Now you can more easily tune back in to the body part, instead of dissociating from it, and this helps you regain control of its functioning. Befriending your body instead of being angry at it helps you approach rehabilitation and self-care with greater attunement, more gently and precisely, instead of with a punitive push-through-it mindset. 


You might even learn feel gratitude for the fact that despite being victimized by some circumstance, this ailing part of your body has continued to carry you, to serve you, doing the best it can.This will not only make it easier for you to regain healthy function, but also make you less likely to have a future body-malfunction. 


When we suppress pain, whether physical or emotional, we tend to do so through energy-depleting muscle tension that further distorts the body's functioning, and buries the original problem in layers of additional ones.




Now what?


Once you realize that pain is simply a call to change something, you can go to work bringing about the change, whether on your own or by enlisting professional help. When we are dealing with musculoskeletal problems, we are basically aiming to restore the normal functioning of the body. An acute injury, muscle spasm or other event can change the way your body works, and this dysfunction may persist until you've "restored your factory settings", usually through the rehabilitative process, such as physical therapy. Once the reason for the pain is gone, there is no need for the body to signal distress, and the pain subsides.


If we throughout the process take into account all the dimensions on which we exist and that affect us, from beliefs and information, nutrition and sleep, emotional stressors, outlets and control, to habits and all the various lifestyle factors that either help of hinder, we stand an even better chance of affecting deep change. 


But it all starts with listening to what our body (and our mind and emotions, for that matter)  is telling us, and accepting the truth and importance of the message. This more harmonious attunement will not only decrease the need for the body to signal pain, but may also deepen our relationship with our bodies, and through that, with life itself.






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