Pain Myths that Keep you Stuck
Pain is confusing. Most of us think that if something hurts, it must be damaged. But modern research shows that pain is much more complicated than that. It’s not just about bones, muscles, or joints, it’s about your nervous system, your brain, and even your life circumstances.
Pain is an alarm system, not a damage meter
Think of pain like an alarm in your house. Its job is to protect you. Sometimes the alarm goes off even if there’s no real danger. Other times, it stays quiet even when tissues are stressed. Pain is your body’s way of saying, “Pay attention, maybe protect this area,” not “you are broken.”
A common example is low back pain. Studies show that most people with back pain do not have dangerous tears, slipped discs, or anything structurally “wrong” on scans. Yet the pain feels real and can limit daily activities like bending, lifting, or even sitting comfortably. This shows that pain is more about how your nervous system interprets signals than just the tissues themselves.
Pain is influenced by many factors
Pain is multifactorial, meaning many things contribute:
- Biological factors: muscles, joints, nerves, inflammation, fatigue, or previous injuries
-Example: Sitting all day can weaken core muscles and make your back more sensitive, even if nothing is “damaged.”
- Psychological factors: stress, anxiety, fear of movement, beliefs about your body
-Example: Worrying that bending or lifting will “damage your back” can actually increase pain.
- Social factors: work, family, lifestyle, support networks
-Example: High work stress, lack of sleep, or little support at home can make your nervous system more sensitive, amplifying pain signals.
Because pain is affected by so many things, two people with the same injury or scan can feel very different levels of pain. This explains why scans alone cannot predict pain.
Why understanding pain is empowering
When you know that pain is influenced by multiple factors, it changes the approach. Pain is not a signal that you are fragile or broken. Instead, it is a guide — it tells you what your nervous system is protecting.
Understanding this can help you:
-Stop avoiding movement unnecessarily
-Reduce fear around pain
-Build confidence in daily activities
For example, someone with low back pain may fear bending forward, thinking they will worsen a disc injury. But gentle, guided movement gradually retrains the nervous system, reduces fear, and can significantly decrease pain.
Movement retrains your nervous system
Because pain is about protection, it can reduce as your body learns it’s safe to move again. Gradual, guided movement teaches your nervous system that things are okay, while also building strength and confidence.
Practical ways to start moving safely include:
-Gentle walking or stretching
-Light core or glute activation exercises
-Gradually returning to activities that were previously avoided
Physiotherapists guide this process safely and tailor exercises to your condition and goals. Over time, your nervous system becomes less sensitive, and everyday movements feel easier.
Other factors that help reduce pain
-Sleep: Poor sleep increases sensitivity to pain.
-Stress management: Stress amplifies the nervous system’s “alarm,” making pain worse.
-Exercise and activity: Gradual strength, mobility, and endurance training helps tissues adapt.
-Education: Understanding how pain works can reduce fear and improve confidence.
The more you combine these strategies, the more likely you are to break the cycle of pain and regain function.
The Good News
Pain is real, but it is not always a sign of damage. Your nervous system can calm down, your tissues are resilient, and recovery is possible. By moving safely, managing stress, improving sleep, and seeking guidance when needed, you can take control of your pain rather than letting it control you.
References / Sources
- Moseley GL, Butler DS. Explain Pain. 2nd edition. Noigroup Publications; 2017.
- Nijs J, et al. “Chronic musculoskeletal pain: what does the neuroscience tell us?” British Journal of Sports Medicine. 2014;48:1553–1557.
- O’Sullivan PB. “It’s time for change with the management of non-specific chronic low back pain.” British Journal of Sports Medicine. 2012;46:224–227.
- Louw A, et al. “The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain.” Archives of Physical Medicine and Rehabilitation. 2011;92:2041–2056.
- Butler DS, Moseley GL. Explain Pain Supercharged. Adelaide: NOI Group; 2013.
Written by our own Rise Physiotherapist, Diarmuid Rowan.
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