Navigating the Physical Experience of Pain

One of the trickiest parts of being a physical therapist is helping people identify and navigate their own coping mechanisms with pain. For many of us who have experienced some form of musculoskeletal pain, understanding what is going on can be quite difficult. As much as it would be nice to have a straightforward explanation, pain is often multifactorial and requires time, attention, and a unique skillset to navigate well. The longer we have dealt with pain, the more it becomes a sort of energetic stress we carry around. How you manage that energetic stress can show up in a number of ways, so when I work with people, I really try to understand, “what’s it like for this person to experience this pain?”

For many people, pain is experienced after an initial injury and follows a logical course of resolution as time goes on from the initial injury. But sometimes the pain just doesn’t go away - we might experience it when try to do something we enjoy and feel discouraged about resuming that activity. We might start to feel like our body is not capable of doing things we really enjoy anymore. Experienced repeatedly, pain can morph our perception of incoming sensations, and sometimes we develop a sort of anticipatory anxiety regarding certain movements. In other instances, we might dissociate from the pain in order to go about our daily routine, but in reality, it’s still weighing us down. All of these behavioral patterns are ways in which we are trying to cope.

In our sessions, I want to make it easier to be “in your body”. This is different than thinking about your body. It’s about developing a place of presence and relaxation internally, even in the midst of ongoing discomfort or unpleasant body sensations. It can be difficult to do this on one’s own, so that is where I can help. There’s a lot of techniques and skillsets I use to facilitate this process and most of the time they don’t involve “thinking”. I try to eliminate the need for any extra work on your end – your brain is already tired from managing what’s going on, and my goal is to off-load this stress in the gentlest way possible.

Once we can establish a sense of ‘ease’ in the body, we can start to work directly with the ‘pain software’ of the body and make some adjustments through interventions that involve your nervous system and musculoskeletal system. These include more hands-on therapies such as manual therapy, dry needling, and vibration as well as exercise therapies such as stretching, motor control exercises, and resistance training. These interventions are typically more restorative in early phases of rehab and more energizing or stimulating as you feel better.

As someone personally familiar to pain in its many forms, I’ve noticed in myself the tendency to turn away it – to not look at something that is painful (avoidance). To dismiss it or overly rationalize it as normal. To blame myself for things I didn’t anticipate or really have control over. Despite trying on all those approaches, the only way I’ve ever been able to grow out of the pain is by accepting it and working with it.

During pain episodes, I’ve had to accept my body’s needs for certain parameters to feel okay. I also recognize that those parameters aren’t fixed – they constantly changing and evolving. Through therapeutic interventions and graduated loading, my body can and will make adjustments to those parameters, such that previously painful movements can become pain-free again.

Learning how to navigate that path is challenging, but I can help you get there. Let's see what we can accomplish together.