Six common pain myths to avoid

Everybody hurts.

But pain is highly subjective, complicated by a mix of signals in the nervous system that can vary from person to person. And that diversity of experience lends itself to a lot of inaccurate ideas about physical suffering.

“People get misguided in belief systems that don’t make any sense or are outdated,” says Jan Dommerholt, a physical therapist and founder of Bethesda Physiocare. “If you look at what’s known about pain—and there’s a lot that’s known—that research would eradicate 50% to 90% of the myths and misconceptions that still circulate.”

Here are six of those myths, according to physical therapists:

Myth No. 1:  Pain is a natural sign of aging

We should expect wear and tear on our bodies as we get older. But to “associate pain as a consequence of age is not necessarily a natural progression, nor correlation,” says Jennifer Norton Graham, owner of Graham Therapy and Fitness in Bethesda. 

Just because we experience hormonal, neurological, musculoskeletal, cardiovascular and other changes as the years pass doesn’t mean that pain is on the horizon, she adds.

While research shows that older adults are more at risk for pain, often because of the increase in falls and chronic diseases, the two aren’t automatically linked, echoes Dommerholt, who is also co-founder of Myopain Seminars, a postgraduate continuing education company for physical therapists and other health care providers.

“There are many elderly people who do not have pain, and there are elderly people with pain—but that’s true in every single age group,” he says.

Myth No. 2:  No pain, no gain

Here’s a common scenario: People who haven’t exercised in decades decide they need to lose 10 pounds immediately and approach an exercise regimen too aggressively, increasing their susceptibility to pain.

No matter the source, pain is not a measure of progress. “Just like in baseball—there’s a preseason for a reason,” says Binila Abraham, a physical therapist at Integrative Therapy in Kensington. “You want to slowly work your way up to discomfort, and maybe just a little bit more. Pushing through something for a long period of time isn’t a good idea.”

It is important to determine what is contributing to the pain, address the area of dysfunction or mechanical limitations, or look deeper into—and tackle—the root cause, says Norton Graham.

“Most people wouldn’t ignore the gas light in a car or an oil light that is on,” Norton Graham says, “so it is important to honor the body’s natural response and work with a health care provider to address any pain complaints and still be successful at achieving the gains.”

Myth No. 3:  Rest is the only way to treat pain

Rest often is required when someone has a new or severe injury, such as a broken bone or sprained ankle, because it aids in the healing process and manages inflammation and other acute issues, says Norton Graham.

But rest is by no means a panacea.

“This is an old-school mentality,” says Abraham, who recently entered a program to become a certified therapeutic pain specialist. “Research has shown that even just a basic level of exercise allows for blood flow to the ‘injured joint’ or whatever it is that ails you.”

Abraham points to a saying in the physical therapy world: “Motion is lotion.”

“It helps to sort of massage and get blood flow to the area so it can heal faster,” she says. “Otherwise you have stasis—that’s when things don’t move. You don’t want that.”

Myth No. 4:  Pain is all in your head

While this one is somewhat accurate because the brain receives signals of pain, “pain is very complex,” Norton Graham says.

Abraham explains that if pain lasts six weeks, one of two scenarios is at play: Either tissue damage has healed but the body’s central nervous system remains on high alert, or there’s something else going on that needs attention.

With the first, “the reality is that the [pain] isn’t there anymore, but our brain has gotten stuck in the position of protect, protect, protect,” Abraham says. With the second, “that’s when you hope you’re being seen and treated by a good physical therapist.”

Abraham suggests desensitizing the central nervous system with some good self-talk. “You can’t dismiss what you feel,” she says, “but you can tell your body, ‘I’m doing everything I can to support you. Thank you for giving me the heads up, but you don’t need to dump the adrenaline anymore. We can settle and take a deep breath and move forward.’ ”

Myth No. 5:  Where you feel pain must be where the problem is located

It seems like a reasonable assumption that if you have heel pain, the source of the pain is in your heel. But that’s not always the case.

“If only the human body were that simple,” Norton Graham says.

For example, pain felt in the heel could be related to the Achilles tendon, plantar fasciitis, bursitis, the pelvis or low back, or a number of other troubles, she points out.

Myth No. 6:  Pain is pain

Just as people are different, so are their experiences of pain. For the same type of injury, one person may have a much higher sensitivity to pain than another, and to think otherwise “could discount what the individual is experiencing,” Norton Graham says.

Care providers often use a visual analog scale—a validated, subjective measure for acute and chronic pain—to determine pain intensity. 

The scale’s questions may include: Is the pain constant, or does it come and go? Is it different throughout the day? What activities make the pain better or worse? Does the pain stay in one place or travel down a limb?

Two people with nearly identical injuries may have wildly different responses to the exact same questions, says Norton Graham.

To get the best help, she says to be sure you’re evaluated by a skilled and licensed health care provider who will “truly listen and dive into what is being experienced and conveyed—and more importantly, why pain is being experienced in the first place.”

This story appears in the November/December issue of Bethesda Magazine.