Pain Science: 4 Myths & Truths

Myth 1: The MRI will show me where my pain is coming from.
Truth 1: The MRI will show you what the tissues inside look like, but we do not always know if what you see on the MRI is actually causing the pain you feel.  Many people have MRI findings without any pain.  Simply this is because pain is the result of many inputs to your brain about threat, not just what has happened to the tissues. 

Additional Notes: Imaging will show you what the tissues look like and they are very sensitive. Imaging's role is to look for and often rule out big problems but they find all kinds of things that are normal changes as well. You can have pain without specific tissue damage so imaging is best used as one piece of the clinical picture. 

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Myth 2: If it hurts when I move I'm causing more damage.
Truth 2: In the case of persistent pain, tissue damage is often no longer the cause for pain.  Sometimes things like fear of movement, or guarding can make a movement feel painful.  Remember that hurt does not equal harm.

Additional Notes: Pain is not always an indicator for tissue damage. It's our body's way of communicating an actual or potential threat. But that threat could be a whole host of things besides tissue damage. It might actually be telling you to move - such as after you've sat with your knees bent for a long time during a movie or roadtrip - your knee hurts but really it's telling you to move. Movement is part of the way our muscles, joints and bones get nourishment and usually part of the healing process. 

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Myth 3: Pain always equates to tissue damage.
Truth 3: Pain often is simply an early warning system to get you to change what you're doing before damage actually occurs. 

Additional Notes: For example, we feel pain when we touch a hot surface before we actually get burned - it's telling us to move our hand. We also know the pain system in our body is present even if we no longer have our body part. Phantom limb pain has taught us a lot about how pain works. 

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Myth 4: Pain means you should rest. 
Truth 4: Most injuries need time, movement, and appropriate loading (PT guided exercises) to resolve and to prevent recurrence.  
 
Additional Notes: Pain is communicating for us to change or do something and sometimes that might be a form of 'relative rest' but most injuries need an early, graduated return to movement and progressive loading to get back to the activities you need and want to do.