Written By: Anthony Kladouris – Accredited Exercise Physiologist
Pain is something almost everyone experiences at some point in their life. Whether it is back pain, knee pain, shoulder pain or persistent pain, it can significantly affect how we move, exercise, work and live.
An important concept within contemporary pain science is that pain does not always equal tissue damage.
Pain is a complex experience influenced by biological, psychological and social factors. Understanding these factors can help reduce fear around movement, improve confidence and give people greater control over their recovery.
What is Pain?
Pain is defined as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.
Importantly, pain is not simply an input from the body; it is an experience.
The nervous system continually processes information from the body, the environment and previous experiences. This process can be influenced by beliefs, emotions, stress, social environment and information coming from the body, all of which can affect how much threat or danger is perceived.
This can help explain why people can experience varying levels of pain from similar injuries or conditions.
Pain is also real. A person’s experience of pain should always be respected and validated.
Complexity of Pain
Everyone wants to think of the body as a machine: find the damaged structure, fix it and the pain should disappear.
However, pain doesn’t always work this way.
Pain is a complex system involving biological, psychological and social factors that all interact with each other.
Due to this complexity, there is no single solution that works for everyone experiencing persistent pain. This is where an Accredited Exercise Physiologist can help implement an effective pain management plan that requires an individualised approach.
Pain Does Not Always Mean Damage
One of the most important concepts in pain science is understanding the difference between nociception and pain.
Nociception is often mistaken for pain, although it is actually the nervous system’s process of detecting and responding to potentially harmful stimuli. Nociceptors act like “alarm sensors”, detecting potentially harmful stimuli and sending information through the nervous system. This information may contribute to a pain experience, but nociception and pain are not the same thing.
Pain can sometimes persist even after an injury has healed, while structural changes can sometimes exist without causing pain.
Just because nociception occurs, it does not mean pain will always be experienced.
Why Can Pain Be Persistent?
Pain usually serves a protective role. It encourages us to protect ourselves when the nervous system perceives a threat.
For example, touching a hot surface produces a rapid protective response that encourages you to move your hand away. However, sometimes the body’s protective system can remain sensitive even after the original injury has improved.
Persistent pain may involve changes in how the nervous system processes information. Stress, anxiety, poor sleep, previous pain experiences and beliefs about injury can all contribute to increased sensitivity, meaning the nervous system can become more protective.
How Can Exercise Help?
Exercise is an important part of managing many musculoskeletal and persistent pain conditions.
Exercise can help people to:
- Build strength and physical capacity.
- Improve physical function.
- Increase confidence with movement.
- Gradually return to activities they enjoy.
- Develop greater tolerance to physical loads.
- Reduce fear around movement.
- Improve general health and fitness.
- Build self-efficacy and independence.
Importantly, exercise does not always have to be completely pain-free.
An Accredited Exercise Physiologist can help determine an appropriate starting point and gradually increase the challenge over time. This may involve changing the exercise, load, range of motion, tempo or number of repetitions.
The process of graded exposure and progressive loading can help people safely rebuild their capacity and confidence in movement. The goal isn’t to simply avoid anything that causes discomfort, but to help the person become more comfortable and confident in the activities that matter to them.
Exercise Is Not The Only Tool
Our bodies are constantly adapting to the demands placed upon them. These demands can include exercise, work, psychological stress and other day-to-day physical and mental loads.
When these demands remain high for prolonged periods, particularly when combined with poor sleep or inadequate recovery, recovery and adaptation can be affected. This is why pain management should consider more than exercise alone.
Improving sleep, managing stress, gradually increasing physical activity and balancing workload with recovery can all form part of an individual’s rehabilitation plan.
The goal is to build capacity and resilience rather than continually avoiding movement.
How Can An Accredited Exercise Physiologist Help?
If pain is affecting your ability to exercise, work, move, participate in sport or complete everyday activities, an Accredited Exercise Physiologist can help develop an individualised plan based on your goals and current abilities.
The plan may involve strength training, aerobic exercise, mobility, balance, graded exposure and load management. Most importantly, pain management should be person-centred. Your pain is real, your experience matters, and understanding your pain can be an important step towards improving your confidence and function.
Pain is complex and is a protective experience influenced by biological, psychological and social factors. Pain is real, but it doesn’t always mean damage.
By understanding pain, gradually increasing physical capacity and addressing factors that can be modified, many people can develop greater confidence in movement and return to the activities that matter most to them.
If you experience pain and it is limiting your movement or quality of life, an Accredited Exercise Physiologist can help you develop a safe and individualised approach to exercise and recovery.