The foundation of good medicine is in determining a correct diagnosis. Without knowing what we are treating, we can’t possibly choose the correct form of treatment. So, when we have musculoskeletal pain, it’s very important to know exactly what is causing it- be it a ligament tear, a tendonitis, a ruptured disk, etc, right?
Wrong. In fact, focusing too hard on understanding exactly what is causing our pain can drive us to seek out excessive medical tests and to spend too much time treating symptoms, rather than solving the underlying issues contributing to our pain.
If we understand pain correctly, that it is a sign alerting us that there is potential danger (it does not reliably tell us the type or magnitude of the danger), we can understand that pain does not always equate to injury. What is important is that we rule out the potential for serious injury or illness requiring immediate medical intervention, which can often be accomplished by a doctor or physical therapist taking a complete history and conducting a thorough physical exam. With serious injury or illness ruled out, I believe that there is often very little value to determining the exact physical source of pain. What we know is that there is a movement problem and that’s all I think we need to know.
With a specific musculoskeletal diagnosis, we sometimes become bound to protocols or site-specific treatments that, if ineffective in alleviating pain, leave us stranded or cause us to chase symptoms. If we simply look at painful movement as a movement problem, we are free to engage in problem solving- in finding and building on movements that are not painful in order to more quickly and effectively restore mobility and function.
As patients with movement problems, instead of injuries, we can let go of the fear of damaging our bodies and feel confident getting back to moving again.