Why does my pain always come back?

To help you get to the bottom of these questions we need to clear up a few things first. You are either repeatedly re-injuring the tissues or your symptoms aren’t from an injury at all… Tissue damage heals within a maximum of 3 months. If the problem were purely an injury to the tissues, the symptoms would have been resolved completely with resting the area – if you recall from a previous article, the human body heals! *Though in the absence of having gone through rehabilitation during the healing/rest period, you may be vulnerable to re-injuring the same area or injuring another area that has become deconditioned. It is because of this that we recommend relative (rather than absolute) rest through rehabilitation while an injury heals.

Any symptoms continuing beyond 3 months (and not getting progressively better during this time), despite having been rested/rehabilitated, or any ‘injury’ that didn’t result from trauma (where bruising was visible), can’t be classified or treated as an injury. In this situation, resting will be of no value and anything aimed at speeding up the healing process is a waste of time (and money!)

So why could you then experience recurrent or ongoing pain? Below are a few possibilities and their common characteristics:

Central Sensitization (an overloaded neural system)

• Chronically tight muscles
• Battling to get comfortable in any position
• Poor sleep and high stress levels
• Pain in multiple areas at once
• Often all on one side including the arm and leg
• Often diagnosed as Fibromyalgia

Mechanical dysfunction (fighting your own mobility)

• Chronically tight muscles
• Produced/relieved in different positions/activities
• One or multiple areas
• Symptoms often changing sides or present on both sides
• Often referred to as
  • ‘An old injury’
  • Arthritis
  • Tendonitis
  • ‘Slipped disc’
  • Pinched nerve
  • Weak ankle, shoulder, knee etc.

Recurrent DOMS

• Erratic training
• Symptoms presenting 24-72hrs after training
• Not typically mistaken for anything else

Others (to name a few)

• Rheumatic conditions
• Infections or tumors
• Obstructed blood flow
• Systemic inflammatory conditions

The first step in correctly addressing any symptom and avoiding a continuation/recurrence, is to make the right diagnosis first. Your health professional should never pull a diagnosis from a hat or simply start massaging/needling/injecting a sore/tight muscle as this is usually a recipe to promote recurrent bouts/ongoing symptoms of the same problem that is left to continue on it’s course or may even make matters much worse! It is for this reason that our therapists systematically work through a comprehensive assessment before any treatment is considered.

Your health and physical wellbeing should be a priority deserving of quality care. Make sure to discuss any concerns you may have directly with your preferred physiotherapist, so that you can receive the appropriate guidance for your unique situation.