Why Getting Out of Pain Isn’t Always Enough
Many people ask the same question when pain doesn’t settle as expected: why am I in pain? As an osteopath, my aim is not only to help people feel better, but to help them understand how they arrived at this point and what may be stopping recovery. Pain is rarely just a signal from injured tissue; it is often shaped by stress, beliefs, workload, and the demands of daily life.
To illustrate this, I have selected a series of soundbites from different patients:
Patient 1: When the Body Forces You to Listen
The first, a full-time student with a wry sense of humour trying to survive on part-time jobs while doing her Masters. She presents with significant pain in the lower back which is starting to limit her life and make work difficult.
At first the problem seems relatively straightforward, but as the treatment progresses and I look for different factors behind the issue, it seems as if more and more of the body has some sort of issue. No matter where I work, something is in pain.
Each time we talk a little more, and it turns out that her pains extend far beyond the lower back, but the back is simply the most painful and limiting. Finally, I land on the right question: “How important is your body’s health to you?” It turns out, a lot less than the other things she must deal with — the reason she has come for help is because her body will no longer let her ignore it.
I now understand why she is in pain. We discuss how to care for the body in a sustainable way that will allow her to do the things she cares about long-term without interruption, and so start to make meaningful progress.
Patient 2: The Cost of Constant Work
The second, a chef — a friendly and bright-eyed lady who has pain in most of the joints in her body. This sends up alarm bells for me immediately; widespread pain is often a sign of underlying illness or an arthritic condition.
As I go through my questions covering possible causes, it comes up that she works 60-hour weeks with little chance to take a break. Things start to take shape for me, and I gently enquire further.
Some time ago, she was scammed into taking on a large loan and now is having to pay it off. She has been working without pause since and will have to for quite a while longer. I now understand why she’s in pain. Sadly, in this case, there is a significant limit to what I can do — this is a factor that cannot be lifted, only managed. Fortunately, there is an end in sight.
Patient 3: Challenging Beliefs Around Chronic Pain
The third, an urbane and well-dressed city worker, has had back pain for about 10 years. He has achieved a high degree of self-management through exercise but cannot fully shake it.
We talk back and forth; I give a thorough physical examination — both active and passive — identify points to work on and give a strong treatment. I suggest further exercises to reinforce changes and am confident that, though this has been there a long time, the problem is still solvable.
His response on hearing this was significantly to the negative: “It’s impossible, this pain will never go.” I now understand why he’s in pain.
I take some time at the end of the appointment to discuss the effect of pain beliefs and find that when he is sufficiently distracted by something he enjoys, the pain does go. I see a slight shift in his face. He later cancels the next appointment because he’s feeling better.
The Common Thread: Listening and Understanding
While each of these patients — and most of the people I see — have an issue with their musculoskeletal system (muscles, joints, bones), often the reason why they’re in pain is found in their story, in the stresses of their regular week, and in their understanding of their own body, just as much as in an explicit physical cause.
For many, it is a listening ear and a proper explanation that helps as much as the treatment. If we can work out whyyou’re in pain, then we can also find a way out of pain — or at least to less.
When pain should be medically checked
Pain is complex, but some symptoms should always be assessed urgently. Seek medical advice if pain is severe, progressive, associated with unexplained weight loss, night pain, numbness, weakness, or changes in bladder or bowel function. When in doubt, it’s safer to get checked.