How Pain Actually Works (And Why It’s Not Always a Bad Thing)

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Pain is one of the most misunderstood signals in the body.
Many people assume pain automatically means damage but in reality, pain is far more complex than that.

Understanding how pain works can change how you move, train, and recover and often helps people get better faster.

Pain Is A Protective Signal, Not A Damage Report

Pain is your brain’s way of protecting you.
It uses information from tissues, nerves, past experiences, stress levels, sleep, and context to decide when to produce pain.

This means:

  • You can have pain without tissue damage

  • You can have tissue damage without pain

Pain is a warning system, not a scanner.

Why Pain Can Linger After An Injury Has Healed

Most tissues heal within predictable timeframes:

  • Muscle: weeks

  • Bone: 6-12 weeks

  • Tendons: longer, but still adaptable

Yet pain can persist well beyond this.

That’s because the nervous system can become overprotective. It stays on high alert, even after the original issue has settled.

This is often referred to as sensitisation.

What can Affect Pain

Think of pain as something that can change and not just go on and off.

Many things can turn the volume up:

  • Poor sleep

  • Stress

  • Fatigue

  • Fear of movement

  • Sudden changes in activity

And many things turn it down:

  • Reassurance

  • Gradual movement

  • Strength

  • Confidence

  • Good recovery habits

Physio isn’t just about the tissue - it’s about helping turn the volume down.

Why Rest Alone Isn’t Always The Answer

Rest can be helpful in the short term, but long-term avoidance often increases sensitivity.

Gentle, progressive movement helps by:

  • Teaching the nervous system that movement is safe

  • Improving tissue tolerance

  • Restoring confidence

This is why modern rehab focuses on graded exposure, not complete shutdown.

When Pain During Exercise Is Ok

Not all pain during exercise is harmful.

In rehab, some discomfort can be:

  • Expected

  • Safe

  • Helpful

What matters is how symptoms respond:

  • Does pain settle within 24 hours?

  • Does function improve over time?

  • Are you gaining confidence in movement?

Pain that spikes and lingers needs adjustment - not panic.

What This Means For Your Rehab

If pain isn’t purely about damage, then rehab isn’t just about “fixing” tissues.

Effective rehab includes:

  • Education and reassurance

  • Load management

  • Strength and conditioning

  • Gradual return to movement

  • Addressing lifestyle factors

This whole-person approach is what leads to lasting results.

Pain can be confronting, but it doesn’t have to control you!!

Understanding how pain works empowers you to move with confidence, make better decisions, and recover more effectively.

If pain is holding you back even when scans are “clear” physio can help you make sense of it and move forward safely.