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‘Go to the pain, not through the pain’ is good advice

September 6, 2009
By MATTHEW GOODEMOTE, For the Leader-Herald

Listening to your body is not always the easiest thing to do, but it is definitely a more effective strategy than listening to the popular saying "no pain, no gain."

Pain is our body's way of stopping us. For example, if you hold a match by your skin, the pain-sensitive nerves, called nocioceptors, register the offensive activity and send an impulse to your brain to move your arm. Most people understand the importance of this system. This is only one way our pain-sensitive nerves warn us.

The nocioceptors are triggered three ways - chemically, thermally and mechanically. The above example with the match is a thermal example. An example of a pain caused by something chemical could be an infection or an inflammation. With a chemical response, there are nerve endings that are triggered when part of our body becomes swollen or inflamed. The chemical type of pain is typically present 24-hours-a-day in the acute stages. It is how we determine what we can do safely with patients and most definitely what should be listened to.

When the mechanical nerve endings are pushed, pulled or compressed, they signal to the body that there is a problem, a problem that we feel as pain. A simple example of this is to pull your index finger back until you feel a stretch, then slowly keep pulling it back until you feel pain.

I know a lot of people like to think we all have different thresholds for pain, but the truth is, we all have about the same threshold for pain. What is different is how we react to pain. The threshold for pain is almost identical throughout all humans. The true threshold is when the nerve endings are triggered, causing an impulse to be sent to the brain. The real difference lies in the brain's interpretation of this impulse.

This cuts right to the heart of what I want to write about today. Our ability to feel pain is a blessing, not a curse. Our interpretation of pain is the problem, not pain itself. So often I hear patients report that they ignore their pain because "things have to get done." Eventually, the pain grows in intensity or more parts of the body experience pain. Finally, the body forces you to stop because you can no longer ignore the pain.

Most everyone has heard the expression "no pain, no gain" at some point in their life. This was originally used to encourage people lifting weights to go to the point of muscle fatigue, because it is, in fact, necessary to build "big" muscles. This is horrible advice for people who are injured and for people who are in pain. There is no physiological reason to ignore pain. Psychologically, there are several reasons to ignore pain (as in "things have to get done"). This is why the mind is the problem, not the body.

I would like to make sure there is no doubt about this. Pushing through pain is not a wise choice if you are trying to get well or if you are trying to get back to the your normal activities quickly. For example, pushing a joint through pain will most definitely slow your progress down. Pushing through nerve pain will most definitely slow your progress down. Pushing through an injured muscle also will result in another injury and a slowdown of progress.

The only time the "no pain, no gain" slogan has any ounce of credibility is when you are training to build your muscles and even in this case there is a limit to how long you should have discomfort. Delayed-onset muscle soreness is the term used to describe the pain felt after exercise and it should only last a maximum of 24 to 48 hours. Anything beyond that is called an injury and should not be pursued - period. If you have an injury, "no pain, no gain" is dangerous. If you have chronic pain, "no pain, no gain" is dangerous. If you have never been taught how to lift safely, this slogan is dangerous. If you are trying to get well and stay well, "no pain, no gain" is useless for you.

Somewhere along the way, the words "go to the pain, not through the pain" came out of my mouth. When I had a chance to reflect on the words, I realized that this is actually very good advice. And when this advice is followed, it allows you to get well again. I am hoping to spread the message loud and clear. No matter what your results have been so far, you can get well.

Let me explain more about what I mean. I believe that in order to truly be well, we need to have balance among these three areas: our physical well-being; our emotional/psychological well-being; and our spiritual well-being. When any one area is out of sync, the rest of them eventually suffer and we do not feel well. When we ignore the pain, whether it is physical, mental/emotional or spiritual in nature, we are led into a wall of suffering. The good news is that we can stop banging our heads against this wall.

Each week, patients report to me how they are "too busy" to hurt. Often these patients readily confess how they have just kept going, even though they have pain and, in some cases, even though they knew they would pay for it later. I am amazed at how many people continue to do things even though their body is breaking down in front of them. I am sure a lot of my patients will think I am specifically talking about them right now. Well, I am!

It is so important to the healing process that you listen to what the body tells you is OK instead of what your minds say is OK. I routinely state to my patients, "When in doubt, trust your body." I often remind my patients that when they trust their mind, they usually end up in trouble. And this principle is not just for physical pain, but includes mental/emotional and spiritual pain and suffering. Most of us have times we pretended we were not upset, only to blow up later over a trivial matter. The pressure is too much sometimes and little things trigger the release of our much bigger emotional/mental pain.

We all have examples of being "temporarily insane," such as believing that we should finish cleaning the house even though our back (i.e. our body) is begging us to stop and rest. Our body is far more intelligent than we are. Our body warns us, and when we still don't listen, it will physically stop us and force us to listen. We were designed to pay attention to the body's warning system. Ignoring it is not a sign of great accomplishment. It is a sign stubbornness of which I am as guilty as anyone reading this.

I am not in any way suggesting that when we hurt we should become couch potatoes and do nothing. I am suggesting that we learn to listen to our bodies so we can work with them instead of against them. When we heal from an injury, we often assume that we got better because we pushed through the pain. Well, I am here to say that we got better despite pushing through the pain. Had we trusted our bodies more, the process would have likely gone faster and been far easier.

Most of us have done things that we know are bad for us, like sitting at the computer even though our neck and upper back muscles are screaming in pain. We push through our pain and make excuses, such as, we "need to get this work done." Then our patients come to us asking us to get them better immediately, so they can go back to doing the very thing that injured them in the first place. One of my professors once described this better than any medical explanation could ever do. He said: "You know, every time I bang my head against the wall, I get a headache. It is the strangest thing. The harder I bang, the worse my headache." Stop for a minute and think of how silly but how true this is. Most people would recognize that stopping is the smartest and easiest solution. But each week at the Wellness Center, we remind people to start with the simple solutions first. The most important solution to most painful problems is to "go to the pain, not through the pain."

Just a few minutes ago, I was talking to an anxious mom about her daughter, who has a minor knee problem. I recommended that we get the problem resolved while it is small to prevent it from becoming a bigger one. This is working with the pain. I never suggested doing nothing about it. In fact, I am a huge proponent of being active. I am only suggesting that we listen to the guidance from our body, not our mind. I will most definitely have the young girl exercising, but we also will be teaching her to primarily listen to her body and following our suggestions secondarily.

Earlier today, I was talking to a patient with chronic pain. I explained how the proper approach (meaning go to the pain, not through the pain) would allow her to feel better and to function better. I am careful to avoid false promises of "no" pain, but part of my reason is that pain is not the enemy. Not listening to the pain is the enemy. Often, when we stop ignoring or trying to avoid or run away from our pain, we find a shortcut back to wellness.

I don't care if your diagnosis is acute, sub-acute or chronic - you can feel better than you do now. Unfortunately, this often requires changing your way of doing things, at least initially. Change can be difficult, unless you are truly ready to feel good again. Then, change is the easiest thing in the world. So often I have patients who really want to get better, but when I suggest that they have to avoid pushing themselves, then they have a very difficult time fulfilling this request.

When you are ready to get well, please use the slogan "go to the pain, not through the pain" as your mantra. It is safer and a lot more effective than "no pain, no gain." When we stop banging our heads against the wall, we can stop and see the doorway to wellness right there in front of us. Pain is there to help us, but only when we work with it. Listening to pain is extremely effective and, if you trust this, I am confident that you can get well again.

Matthew Goodemote, a Gloversville native, owns Community Physical Therapy & Wellness. His Health & Wellness column will answer your questions and discuss topics that are relevant to your everyday way of life. If you would like to ask a question, e-mail Matthew at goodemotept@yahoo.com.

 
 

 

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