Pain is a fundamental part of life, but defining it can be slightly tricky. The International Association for the Study of Pain describes “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”1 but the reality of the sensation of pain can be hard to put into words. Pain arising from an acute injury, like a sprain or muscle tear, is something we can easily relate to, but what if the pain persists longer than the actual time it takes to heal?
For a lot of persistent musculoskeletal pain, the level of pain we experience may not relate exactly to the level of damage. Increasing numbers of studies have shown that many people can have common MRI findings such as herniated discs2, rotator cuff tears3, and knee osteoarthritis4 without any pain or symptoms. There are two major outcomes from this growing research. First, in many cases, it is possible to continue moving/training/playing and doing what you love without invasive treatment. Second, when pain is present, it does not mean that you are ‘damaged’ – it is possible to regain full function without worrying about what are normal changes to the musculoskeletal system.
Based on the above research, when we experience musculoskeletal pain it may be better to think of it as a warning system which is still flashing after the ‘danger’ of an acute injury has passed, rather than an indicator that we are at risk right now. Pain is not ‘in your head’ – it is a very normal experience arising from this warning signal in your nervous system, and it can be influenced by our health and psychology, our environment, our fears, beliefs and worries5. The goal of evidence-based osteopathy is to support you in calming down that warning system, helping to relax your body and to give you the tools you need to get back to living your life, on your terms.
1. International Association for the Study of Pain. (2020). IASP Announces Revised Definition of Pain
2. Brinjikji, W., et al. (2015). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology, 36(4), 811-816.
3. Teunis, T., Lubberts, B., Reilly, B.T., & Ring, D. (2014). A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. Journal of Shoulder and Elbow Surgery, 23(12), 1913-1921.
4. Culvenor et al. (2019). Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and metaanalysis. British Journal of Sports Medicine, 53, 1268-1278.
5. Bevers, K., Watts, L., Kishino, N.D., & Gatches, R.J. (2016). The Biopsychosocial Model of the Assessment, Prevention, and Treatment of Chronic Pain. US Neurology, 12(2), 98-104.