Pain is an essential part of the human experience, guiding us through physical challenges, alerting us to potential harm, and helping us better understand our bodies. As a physio who specialises in women’s health, I work with many clients who face various pain experiences, from acute injuries to chronic conditions. Understanding pain and how it functions can provide valuable insights into managing it effectively—and sometimes even embracing it. Here’s what you need to know.
What is pain?
Pain is a complex interaction between the body and the brain. When we experience an injury or stress on the body, sensory receptors called nociceptors are activated, sending signals through the nerves to the brain. This process is essentially the body’s way of saying, “Pay attention! Something might need help here.”
However, pain isn’t only a physical response. It’s deeply intertwined with our thoughts, emotions, and past experiences, meaning each of us perceives pain uniquely. Sometimes, even without significant physical injury, the brain can interpret signals as painful due to stress, fear, or past trauma. This brain-body connection can significantly influence how we perceive pain and, therefore, how we respond to it.
Acute pain vs. chronic pain
Acute pain: This type of pain is often a result of an immediate injury or strain. It’s the sharp, clear sensation you might feel if you twist an ankle or pull a muscle. Acute pain typically serves a purpose by prompting us to rest and heal, and it usually subsides as the body repairs itself.
Chronic pain: Chronic pain is often defined as pain that persists beyond the typical healing period (usually around 3–6 months). Unlike acute pain, chronic pain can sometimes continue without an obvious injury or physical damage, largely due to changes in the nervous system. Over time, the body can develop a heightened sensitivity to pain, even when there’s no immediate danger, creating a feedback loop that’s challenging to break. For many people, managing chronic pain requires a multifaceted approach that goes beyond simply addressing the physical injury.
How the brain influences pain
Our understanding of pain is rapidly evolving, with more evidence highlighting how much the brain shapes our pain experience. This process is known as “central sensitisation,” where the central nervous system becomes more sensitive to pain signals, making us feel pain more easily and intensely than before. Factors like stress, poor sleep, anxiety, or trauma can contribute to this heightened sensitivity. So, when someone with chronic pain exercises or tries new activities, their pain may feel exaggerated due to this sensitisation.
The good news is that there are ways to retrain the brain’s pain response. Physiotherapy techniques, mindfulness, and graded exercise (starting slow and gradually increasing intensity) can help reduce the brain’s sensitivity to pain over time.
Why it’s okay (and often beneficial) to feel some pain during exercise
Experiencing some discomfort or mild pain during exercise is common—and even expected. Here’s why it’s often beneficial and how to navigate it safely:
Normal adaptation: When you exercise, especially if you’re trying something new or increasing intensity, your muscles and tissues need to adapt to the load. This process can result in temporary muscle soreness, known as delayed onset muscle soreness (DOMS), which usually peaks 24–48 hours after a workout. While DOMS can feel uncomfortable, it’s generally a positive sign of muscle growth and adaptation.
Building resilience: Exercise can help build resilience in the nervous system. Controlled exposure to discomfort can actually help the brain reframe its interpretation of pain signals, teaching it that some levels of discomfort are safe and non-threatening.
Graded exposure for chronic pain: For those with chronic pain, graded exposure is especially important. Starting with gentle, low-impact exercises and gradually increasing the load can help desensitize the nervous system, reducing pain over time. Learning to distinguish between “hurt” (muscle soreness or adaptation pain) and “harm” (a sign of injury) can empower you to exercise without fear of exacerbating pain.
Mental health benefits: Movement and exercise are powerful tools for managing anxiety, stress, and depression, which can all influence our experience of pain. By embracing the small discomforts that come with exercise, we allow our bodies and minds to enjoy these benefits.
How to approach pain in exercise
If you’re dealing with pain during exercise, here are some key pointers to guide you:
Listen to your body: Distinguish between “good pain” (muscle soreness, effort-related pain) and “bad pain” (sharp, stabbing pain or pain that limits movement). Knowing your body’s limits can help you avoid injuries while still challenging yourself.
Take it slow: Especially for those managing chronic pain, start with gentle activities, such as walking, swimming, or low-resistance strength exercises. Gradually increase intensity as your body becomes more accustomed to movement.
Use the "traffic light" system: Imagine a traffic light where green means mild, tolerable pain; yellow means moderate pain that feels uncomfortable but manageable; and red means sharp or severe pain. Aim to keep your activities in the green or low-yellow zone, especially in the beginning.
Practice mindfulness: Techniques like deep breathing, body scans, or visualisation can help you tune into your body, allowing you to observe discomfort without judgment. Mindfulness can also lower stress, which is essential for managing pain.
Final thoughts
Pain is a complex, subjective experience with both physical and emotional dimensions. While it’s natural to want to avoid pain, especially if you’ve dealt with chronic issues, understanding and embracing some level of discomfort during exercise can be empowering. Movement not only strengthens the body but also helps retrain the brain’s response to pain, offering you the tools to build resilience and regain confidence in your body.
If you have specific questions about managing pain during exercise or want guidance on a safe exercise plan tailored to your needs, please reach out. At Ali Cann Physio, I’m here to support you in your journey toward pain management, strength, and resilience.
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