Top 9 Pain Myths You Must Stop Believing!

Today, we’re addressing a topic that affects all of us: pain. In this blog post, I will debunk the nine most common pain myths using research, and provide you with a better understanding of your pain, so you can manage it more effectively.

Myth #1: Pain means that tissue is damaged

Pain is more about sensitivity than damage. Let me explain this in more detail.

Of course, when we take a classic example like a bone fracture, tissue damage is highly associated with pain. But you’ve probably heard from many people, or maybe you’re one of them, who have experienced prolonged pain without any specific trigger like an accident.

Or do you know the feeling when you have more stress in your life, for example at work, or when you’ve slept less, that you experience more pain than usual?

At that moment, you didn’t suddenly have more tissue damage, but simply more stress. That’s exactly why you were more sensitive to pain.

I’ve also made an Instagram post about this. I’ll show it to you here:

The illustration nicely shows that it’s actually the cumulative effect of all the stressors in your life that eventually leads to crossing the ‘pain threshold’ and experiencing pain.

To emphasize this point again, tissue damage doesn’t automatically mean pain. There’s a well-known study by Brinjikji et al. that demonstrates many people have disc degeneration and herniations without experiencing pain.

To clarify, an additional illustration:

Ultimately, your body uses pain to simply encourage you to make changes: to move more, to move differently, or to reduce stressors in your life.

Myth #2: Imaging techniques (MRI, X-ray, etc.) find the cause of pain

The study by Brinjikji et al. illustrates very well that imaging techniques are often not very conclusive when it comes to pain.

Don’t get me wrong, imaging techniques definitely have their place. In my opinion, however, they should be used much less frequently and not as the first measure for many pain presentations.

When imaging is performed, the results should be critically evaluated. Suppose you have pain in your left knee and get an MRI. The image reveals a small longitudinal tear and some meniscal degeneration.

You often hear from doctors that this is the reason for the pain.

I would view this critically because it’s quite possible that your right knee, which wasn’t examined, has a much larger tear or more wear and tear, yet you don’t have pain there.

The takeaway from this point is that imaging techniques can only be one possible piece of the puzzle when it comes to understanding pain, and they are not the sole solution to identifying its cause.

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Myth #3: You have pain because you have poor posture

There’s a very good study by Swain et al. from 2019, which reviewed over 4000 studies to check whether there’s any validity to the hypothesis that there’s a connection between your posture and pain.

They found that there is no clear link between your posture, prolonged sitting, prolonged standing, or physically demanding work and lower back pain.

From this, you should understand that there is no perfect posture and that it is most likely not the primary cause of your pain.

Of course, if a certain posture causes you pain, then change your posture for a while.

But as I said, the cause is very unlikely to be your posture.

Myth #4: There are pain receptors in the body

There are no pain receptors, only danger receptors that can detect threats in your body, such as too hot, too cold, too much pressure, too sharp, too pointed, or anything else (Dubin & Patapoutian 2010).

The danger is then relayed to the brain, which results in pain. Put simply.

Myth #5: Pain must be either in the body or in the head

I often hear from athletes that they’ve been told their pain is all in their head or that they’re imagining it.

This viewpoint dates back to the 17th century, yet it’s still commonly heard today that people are told they’re making up their pain or that the pain is just in their head.

Even if someone is experiencing physical pain, they’re often told it has nothing to do with their psyche.

However, more modern, holistic theories of pain have emerged, clearly showing that we cannot separate the body and mind (Cormack et al., 2023).

Myth #6: You should only resume or return to sports when the pain is completely gone

This perspective feels like it’s from the 17th century because it’s overly simplistic.

There are many pain issues where you can continue training without taking a complete break from sports.

It’s more about properly managing the load: controlling the range of motion, the pace of movement, how often you perform the exercise, how intense it is, how many sets you do, and the complexity of the exercises.

With these six adjustments, you can make significant changes, allowing you to start exercising again very early or even avoid a sports hiatus altogether.

Of course, if you have, for example, a hamstring strain and it hurts terribly to train your hamstring muscles, I would refrain from doing that exercise for a while and wait for some relief.

However, there are hundreds of other muscles in your body that you could continue to train without issues if you adjust these six variables.

For instance, if you still want to train your lower body, you could adjust the complexity by opting for less complex exercises like hip abduction on a machine or seated calf raises.

This way, you can continue training while giving your hamstring time to recover.

When you experience pain, it’s important to give your system—this includes not just the muscle but also the nervous system—enough time to recover. If you trigger pain too often, your body learns to feel pain, which can further promote pain occurrence.

This process is called central sensitization (Van Griensven et al., 2020). Remember the earlier point about becoming more sensitive to pain?

The good news is that this process can also be reversed. If you avoid triggering pain for a prolonged period, central sensitization can diminish, reducing your pain levels and making you less sensitive to threatening signals.

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Myth #7: You have pain because you performed exercise XYZ incorrectly

Attention newsflash, there is fundamentally no best way to move.

One joint often criticized for incorrect movement is the shoulder blade. Corrective exercises are frequently done to optimize shoulder blade movement, and on this topic, Salamh et al. published a new paper in 2023 observing over 2000 people with or without shoulder pain.

They found these incorrect shoulder blade movements in over 50% of people without shoulder pain. While there may be movements you perform too often, too intensely, or too consistently, the movement itself is not inherently bad.

Simply aim to incorporate as much variety as possible into how you move, and then you won’t need to worry about this belief anymore.

Myth #8: There is always a clear cause for your pain

At least for most musculoskeletal pains, such as those involving cartilage, bones, ligaments, muscles, tendons, etc., it’s often not necessary and typically not even possible to pinpoint a single cause for your pain.

A classic example of this is lower back pain.

90% of all lower back pain cases are nonspecific. This means there is no clear pathology that explains why the person has back pain.

Another classic example is the shoulder. I discussed this with one of the world’s most renowned shoulder physios, Adam Meakins. There are simply so many structures in such a confined space that it’s not feasible to isolate one specific structure as the cause, nor can therapy be targeted solely at that one structure.

When you move your arm in any way, all structures are always involved. Looking at exercise protocols from shoulder studies, the following can be observed: whether it’s the bursa, the long biceps tendon, the supraspinatus tendon, or anything else, the therapy protocols all look the same (Shire et al., 2017).

That’s why my advice is: don’t stress about finding one specific cause for your symptoms. If someone tells you that this specific structure or muscle is to blame for your pain, you should always approach these statements very critically.

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Myth #9: Chronic pain is incurable

Often people think that when they hear the word ‘chronic,’ the pain will never go away.

However, the term ‘chronic’ actually says more about the past than the future. Chronic pain is simply pain that has persisted for more than three months.

So, as I said, it’s about the past. There are many different types of chronic pain, and indeed, conditions like fibromyalgia typically do not go away, and people have to learn to live with them.

But for many pains labeled as ‘chronic’ by healthcare professionals, you can expect that they can go away in the future.

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