What is pain and how does it work
In Physical Therapy school, we learn that there is a difference between “hurt” and “harm”. If things hurt, it means that your brain is telling you “ouch!”, whereas “harm” means that there is a bodily injury or tissue damage. In many instances, something may “hurt” even without any real tissue damage. In other instances, something may be harmful but not produce any hurt.
Take for example an athlete in the middle of a competitive game. We have all seen feats of athleticism performed by individuals with broken bones or other horrible injuries. In these cases, something is harmed but the athlete is feeling no hurt so they are able to continue to play through the injury. That is because the brain is so focused on the game that it is ignoring the painful stimulus that is coming from the harmed tissue. The brain is also being bathed in a powerful neurotransmitter commonly known as adrenaline. In this state, the “hurt” doesn’t register even though there is “harm”.
The opposite is also possible, which is that there can be “hurt” without “harm”. If the body is in pain for a prolonged period of time, the brain gets used to registering that pain stimulus. Then, even after the tissue has healed, the brain is still registering that “ouch” feeling. This is when pain becomes chronic. Because so much of pain is rooted in the brain, it is not always a good indicator of tissue damage or injury. You can feel pain when you hurt yourself, but you also may not. That is why it is so important to work with a physical therapist or other musculoskeletal expert to truly assess the source of your pain.
Sometimes, in order to heal, things may “hurt”. But hurt does not always equal harm. As you start to recover, it takes time to build your pain threshold back to where it was before. With proper rehab and guidance you can gradually stress and strengthen your tissues safely. Over time, your brain will see that activity is not causing harm or risking further injury so your pain threshold will begin to reset and will eventually return to normal.
