Maybe you’ve had one of these seemingly unexplainable but painful experiences:
- You didn’t do anything unusual yesterday but your back has been spasming since you got out of bed today
- You broke your ankle 20 years ago and multiple x-rays and doctors said it healed — but now it's your internal barometer and tells you when a storm is coming
- You had a crummy day at work and then screamed when you got a tiny papercut
- You once injured your knee skiing and now instinctively grab your leg when you watch someone crash in the Olympics slalom race
- You can run, bike, ski without any issue but the minute you bend down to pick laundry up off the floor, pain shoots down your leg
You’re not imagining things. Your pain is real, but it doesn’t necessarily mean that there is alarming physical damage hiding in plain sight.
Pain is a complex system of signals that involves the nervous system, the brain, and receptors throughout your body that are always evolving in response to your lived experience.
In order to experience pain, your nervous system must communicate it to your brain. This is why some people with spinal cord damage don’t feel pain below the level of their injury. This puts them at higher risk for injury since the message isn’t being received by their brain to tell them to react and move away — like many people would if they touched a hot stove.
Alternatively, sometimes injury turns up the volume on pain. If you’ve had an injury to a tendon in the past, this tendon can develop an increased number of pain receptors. This is an adaptation that your body makes to let you know, ‘Hey! Stop ignoring me! We need to pay attention to this tendon here!’
A common downfall of that strategy, though, is that the response to pain can become heightened because of these adaptive receptors, and can last much longer than the injury itself. In other words, you can respond to the pain, make all the right changes, and continue to have the sensation that pain is still heightened.
Since pain is interpreted in the brain, it is often influenced by stress, fear, and our lived experiences. Have you seen this famous experiment? (He says there is no science happening here, but the ‘magician’ is reenacting real experiments with real results.) This study was first done to help scientists understand phantom limb pain — the pain someone feels in an amputated limb after it is gone — in the 1990s.
We are also more likely to experience pain during stressful periods of time in our lives. If you’re experiencing back pain flare-ups at the worst and most inconvenient times - it may be that back pain is what is running over when your cup, or capacity, is already full. You have a project due at work, your spouse is out of town, the kids are sick, the news cycle is horrifying, and you had to put your most beloved pet down a few months ago. Maybe it actually hits not during life’s most stressful periods, but after, when everything has finally calmed down. It’s similar to how you might have always gotten sick the week after finishing your college finals.
We can’t always control for all the factors influencing pain, or maybe even name them all. It is truly that complex! What we can control, and what I spend a lot of time working on with my clients, is improving our capacity so that our bodies are less reactive to stress and pain.
Improving capacity can look like a lot of things:
- Improving sleep quality
- Improving tissue quality (for the tendon that is still highly sensitized, for example)
- Improving strength so that you can lift more while stressing your body less (instead of filling your cup less, make the cup bigger)
- Resistance training to improve metabolic health (I’m saving all my thoughts about how metabolic health impacts pain for another newsletter)
- Decreasing inflammatory triggers, like alcohol
- Using stress management tools effectively
- Building success through small actions so that your body positively adapts to stress
This last one is important and complex. I’ll save more on that topic for another newsletter too.
This is all just to say, go easy on yourself right now, especially if pain seems to be flaring up more than usual. And of course, reach out if you’d like to understand how all of this is relevant to your own experience.
Warmly,
Katy
P.S. If this sparked a lot of thoughts or questions, this is a great (although already somewhat dated) read.
P.P.S. If you learned something from this newsletter please pass it on to someone you think might benefit from reading it.