Understanding Pain and Injury
To experience pain after injury is a natural response, signalling potential damage to the body. Soft tissue injuries, joint pains, and nerve-related conditions are common causes of pain and discomfort. These conditions can significantly impact your daily activities and overall quality of life. Physiotherapy plays a vital role in managing these conditions by assessing symptoms, determining their root cause, and providing appropriate interventions to promote healing and improve function.
But first, what exactly is ‘Pain’?
Pain is defined as “an unpleasant sensory and emotional experience associated with, or resembling, actual or potential tissue damage”
Or in more simpler terms, it can be interpreted that;
– To experience pain you do not necessarily need to experience any tissue damage
– But equally, having tissue damage does not necessarily lead to pain.
Confusing, right?
IMPORTANT: It’s really important at this stage to point out that pain is not ‘in your head’ or thought up by any means. Pain is a true lived experience, and an unpleasant one at that!
Types of Pain
Pain can be classified into three types: acute, chronic, and referred pain. Understanding these types helps your physiotherapist determine the best course of treatment and address the underlying issue effectively.
- Acute Pain
Acute pain arises suddenly, often following an injury or trauma such as a muscle strain, ligament sprain, or joint injury. It is usually sharp and intense, lasting from a few hours to several weeks. Acute pain signals immediate tissue damage or inflammation. - Chronic Pain
Chronic pain persists for longer periods, typically beyond three months, and can result from unresolved soft tissue injuries, degenerative joint conditions, or nerve irritation. Common examples include chronic back pain, tendinopathy (previously known as tendonitis), or joint arthritis. - Referred Pain
Referred pain occurs when pain is felt in a different area of the body from where the injury or problem originates. For example, nerve irritation in the neck or lower back can cause pain radiating into the arms or legs, such as in sciatica. Physiotherapists assess referred pain by identifying the root cause and delivering interventions to address the source of the discomfort.
Common Injuries and Conditions Treated with Physiotherapy
Physiotherapists are trained to treat a wide variety of conditions, particularly those involving soft tissue injuries, joint pain, and nerve-related conditions:
- Soft Tissue Injuries
These injuries affect muscles, tendons, and ligaments. Common examples include:- Sprains: Damage to ligaments, often due to twisting or overextending a joint (e.g., ankle sprain).
- Strains: Injury to muscles or tendons, such as a pulled hamstring or rotator cuff tear.
- Tendinopathy: Overload response of a tendon, commonly due to overuse or repetitive motion (e.g., tennis elbow, Achilles tendinopathy).
- Bone and Joint Pains
Joint pain can result from injury, overuse, or degeneration. Examples include:- Osteoarthritis: Degeneration of joint cartilage, commonly affecting the knees, hips, and hands.
- Bone Stress; An overload response to the bone, particularly weight bearing joints (e.g., ‘Shin splints’ or Stress fractures)
- Nerve-Related Conditions
Nerve-related pain occurs when nerves are compressed, irritated, or damaged, leading to symptoms such as pain, numbness, tingling, or weakness. Conditions include:- Sciatica: A term used to describe pain that radiates from the lower back into parts of the lower leg
MYTH BUSTER: Sciatica is typically associated with a single nerve root injury close to the spine, and is rarely actually caused by the Sciatic nerve.
- Carpal Tunnel Syndrome: Compression of the median nerve in the wrist, causing pain, tingling, or numbness in the hand.
- Cervical Radiculopathy: Similar to Sciatica -a nerve root compression in the neck, which may cause radiating pain or weakness in the arms.
What else influences pain?
· Sleep – studies have proven that those who have poor sleep quality are more likely to have a lower pain threshold (1)
· Weight – Those who are overweight or obese, will typically carry more adiposity (fat cells), which results in higher Leptin levels – a hormone produced by fat cells. Higher leptin levels have been associated with more widespread pain and lower pain thresholds (2)
· Hormones – Higher levels of testosterone in men leads to a higher pain threshold, whereas fluctuations or reductions in oestrogen leads to pain sensitivity (3). This is particularly relevant for those peri-and post-menopausal who are experiencing an ongoing issue.
The Role of Physiotherapy in Pain Management
Our job as Physiotherapists, is to differentiate the potential causes of your pain and implement an appropriate plan to aid your recovery or management of a condition.
The role of a physiotherapist is to assess your symptoms, determine the root cause of your pain, and deliver appropriate interventions to effectively manage the condition. This often involves a combination of the following approaches:
We use a 3-step approach to facilitate your return to health
- Assessment – During the assessment we’ll collect information about your issue, the timeline of events leading to your symptoms, and a little about you, your health and your lifestyle. We’ll then run through some physical tests to measure your flexibility, strength and function.
- Analysis – This is where we piece together all our findings to give you clarity on your symptoms. We’ll communicate what we think is causing your symptoms, the stages required for your recovery, and some guidance on expected timeframes to recovery.
- Action – And here we’ll intervene. Our treatment may involve hands-on soft tissue techniques, joint mobilisations, or acupuncture, alongside a supervised rehabilitation programme. The rehabilitation will be a huge part of your plan as this is what will give you the long term, long-lasting results!
Tips for Managing Pain and Reducing risk of injury
- Keep moving: Where pain allows keep moving. The body’s healing processes respond best when you’re active so simply ‘resting’ won’t optimise your recovery rate.
- Fuel: Your body will need nutrients to fuel the recovery process so keeping a diet high in protein and vitamins will aid this.
- Follow Your Physiotherapist’s Advice: Trust the process and know that our aim is to deliver long-lasting results, helping you get back doing the things you love!
Conclusion
Soft tissue injuries, joint pain, and nerve-related conditions can be debilitating, but physiotherapy offers a comprehensive and effective solution. By assessing your symptoms, identifying the root cause, and delivering targeted interventions—including manual therapy, exercise programming, and education—your physiotherapist can help you manage pain, recover more quickly, and prevent future injuries. Adhering to your treatment plan and staying consistent with rehabilitation exercises is key to achieving the best possible outcome.
It’s really useful to understand how other factors and variables in day to day life can influence pain, as this can dramatically help your management of a condition and speed your recovery up.
1. Sivertsen B, Lallukka T, Petrie KJ, Steingrímsdóttir ÓA, Stubhaug A, Nielsen CS. Sleep and pain sensitivity in adults. Pain. 2015 Aug;156(8):1433-1439. doi: 10.1097/j.pain.0000000000000131. PMID: 25915149.
2. Aronsson M, Bergman S, Lindqvist E, Andersson MLE. High leptin levels in blood are associated with chronic widespread pain in rheumatoid arthritis. Arthritis Res Ther. 2024 Dec 23;26(1):228. doi: 10.1186/s13075-024-03463-x. PMID: 39716315; PMCID: PMC11664876.3. Athnaiel O, Cantillo S, Paredes S, Knezevic NN. The Role of Sex Hormones in Pain-Related Conditions. Int J Mol Sci. 2023 Jan 18;24(3):1866. doi: 10.3390/ijms24031866. PMID: 36768188; PMCID: PMC9915903.
