The most reasonable answer is: It depends! Surprise, surprise, right? But trying not to be on the fence, I would say most definitely, yes, you should. Although we must have heard some examples, every now and then, of people saying they have no pain issues even later in life, I would say this is rather uncommon. Pain is part of life, and as such we must learn how to deal with it when it happens. Bear in mind I’m not saying that you should just accept living a lifetime in pain, but rather how to manage it to allow better health outcomes and quality of life.
Our perception of pain
First thing to consider is that pain does not equal harm. There is a very strong body of evidence showing that people with no symptoms can present findings on imaging scans. And also that people with positive imaging findings can show no symptoms at all. What that means is that our perception of pain goes well beyond structure. Confusing? I agree. But I would rather say reassuring. I see people everyday asking if my scans show that there is nothing wrong, why does it hurt? Bear with me, we’ll dig deeper.
Another important factor is that pain is not (only) a physiological warning to say something is wrong. It can be a useful tool to protect us against potential harm, but pain can better be described as an experience. No, I’m not saying that pain is psychological and it does not exist, although psychological factors do play a role. Pain is an output of the brain. Our brain receives and interprets a multitude of information regarding pressure, temperature, tension, chemical reactions, position and so on. Things that we have felt, seen, read and heard, shape the way we experience all of this information.
There is a very interesting case from the 1990s where a civil worker stepped on a 15cm nail in a construction site. The nail went all the way through his boot and foot. When I tell this story, most of my patients grimace and turn their faces away as if they could feel his pain. I get how cringe worthy it can be. He was taken to A&E and with every slight movement of the nail causing intense levels of pain, he had to be sedated for the nail to be removed. After getting the nail and boot removed, the medical team saw that this patient didn’t suffer a scratch as the nail went in between his toes.
People always reply in awe: How is it even possible? And I ask: You grimaced. Have you ever had a nail piercing your foot? Some of them have, some haven’t. The ones who have, remember their unpleasant EXPERIENCE. The ones who haven’t, sometimes say they have SEEN someone going through it with the person crying in agony. So, it’s very easy to imprint on our brain “nail in the foot = huge pain”, right? Who wouldn’t react in agony having a huge nail deeply penetrated in the foot. Remember what I said: things that we have, seen, heard and felt, shape the way we experience pain.
Let’s see the glass half full here. If pain is experienced with no apparent structural change or damage what is the harm of trying some movements or engaging with exercise? All we need to do is to be smart and manage how we are going to gradually expose ourselves to whatever we want to do. And this goes beyond sports activities. It could be a simple stroll in the park with our little ones despite having pain in the knee. It could be kneeling down to do some gardening, or playing tennis on a painful neck.
Pain does not equal harm
So, how do we do it? Remember, pain does not equal harm. So, should we fight through pain and play the “no pain no gain” game? Definitely not. We need to calm things down and build things gradually back up. We need to gradually expose ourselves to the tasks or task derivatives that we want to do and rather than focusing on what we can’t do, we should find a way around it, modify the task and gradually expose ourselves to it.
If you consider your level of pain to be something between 3/10 to 4/10 on a pain scale, as a result of a given task or activity, you are good to go. But for some people, it is hard to properly determine what a 6/10 might feel like compared to a 1/10. And this is subjective and hard indeed. So, I normally say, if this given task or activity you want to do causes you to be aware of the body site, and does not make you limp or change the dynamic of the movement, go for it. But don’t go crazy. If pain makes you grimace, and causes over compensations, then we should try and modify some aspects of it.
Exercising with pain is often safe
Exercising with pain is often safe and can be beneficial if approached wisely. It involves understanding that pain is a multifaceted experience, recognizing the difference between pain and harm, and gradually increasing activity levels. If you are in doubt, we can definitely help you here at Physio4Life to ensure you’re on the right path to maintaining an active and healthy lifestyle despite pain.