The Tissue Is Not The Issue

Pain is a very important protective sensation, it lets us know that we’re touching a hot iron, if we’ve over done it a tad durring an intese workout, or when we’ve stepped on a tac…ouch!


However, there are many individuals who experience pain even if there is no longer a stimulus causing it. This is called chronic [or persistant] pain and it is a very serious and complex issue, I won’t begin to pretend that I can cover all facets here in my blog today. However, lets just consider:

If there isn’t a torn ligament or a pesky tac stimulating pain, we must being to look for reasons why our patients still experience pain. Ultimately, it is because all pain (whether it is from a tac or a chronic issue) is produced in the brain. The pathways in individuals who have chronic pain have become overly sensitive and the slightest stimulus (movement, feather, tac…) are painful.

 In many respects the health care community has failed individuals with chronic pain by simply over medicating or ignoring conservative treatment. We have to recognize that while an individual may have chronic shoulder pain, the tissue (shoulder) is NOT the issue.


So if the tissue is fine, we have to retrain the brain and the pathways to allow for pain free movement. There are some very interesting ways the physical therapists (movement specialists!) can help…but maybe I’ll save that for another day.

Finally, I just want to emphasize that while ALL patient centered care has to focus on education and understanding, it may be more essential perhaps with this population. After all these individuals have been in pain for a long time and may have been written off as simply ‘crazy’ by other health care providers…since that tricky tissue seems juuuust fine.

Interested in learning more? Check out this awesome youtube video: Understanding Pain  


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