Of course, it’s quite obvious that no one wants to be in pain! The moment someone feels pain, they try to get rid of it as soon as possible. Pain is basically an unpleasant experience and hence no one wants to have it, but most of us fail to realize that it has a purpose.

What is ‘pain’?

Pain is an alarm generated by our body to convey that an internal organ is at fault. When the blood supply to the heart is inadequate, a person experiences severe chest pain. A stone in the kidney causes back pain. The same holds good for a common neck pain, back pain, shoulder pain or any other joint, where the pain indicates that some structure in that joint is affected and faulty.

Should we treat pain?

Treating the pain is to “switch off” the alarm, whereas the reason for the alarm still remains unattended. Temporary suppression of pain results in silent progression of the underlying disease leading to grave complications. Hence when the cause of pain is treated, pain vanishes by itself.

Do we really need an x-ray or MRI to treat pain?

The treatment should be based on a detailed patient history and physical assessment. Radiological(X-ray, MRI) or laboratory investigations should be used only to rule out any potentially harmful diseases. ex: osteoporosis, tuberculosis of the spine, rheumatoid arthritis, bone cancer, fracture, dislocation etc.

Does pain mean “arthritis or spondylosis”?

Arthritis and spondylosis are the two most common names given to the condition, where people (without a history of recent injury) complain of pain and stiffness in the major weight-bearing joints such as the knee, hip, neck and back. The pain is usually attributed to the degenerative(wear and tear) changes due to ageing and hence it was believed to affect the old aged population. Recently such pains have become prevalent even in the younger age groups and they are made to believe that their joints have undergone early degeneration and hence the pain. Based on the region of pain they are named as osteoarthritis of the knee, hip, cervical spondylosis and lumbar spondylosis.

In addition, when other joints are involved they are given fixed diagnostic titles like periarthritis shoulder(shoulder pain), tennis elbow(outer elbow pain), golfer’s elbow(inner elbow pain), calcaneal spur(heel pain), plantar fasciitis(foot pain) and the list goes on. In reality, degeneration(wear and tear in the joints) is never proportional to pain. To be precise, patients without degenerative changes may have severe pain and those with degenerative changes may have lesser pain or may not have pain at all. Hence we should understand that no single cause (degeneration of joints) can be attributed to pain, and the cause of pain varies from person to person.

Should we treat pain based on these diagnostic names?

These diagnostic names(spondylosis, arthrosis, plantar fasciitis etc) are only meant for the “ease of communication” regarding a patient’s condition. They very much lack in specifying the exact cause of a disorder, which could be found only by an individualized physical assessment. Treatment should be directed towards the cause of the disorder and not towards the diagnostic names.

What causes pain?

  • Improper posture sustained for a long time
  • Faulty movement patterns
  • Short and tight muscles
  • Weakened and abnormally stretched muscles
  • Restricted mobility of nerves
  • Excessively stretched fascia (it is a layer of tissue under the skin)
  • Unequal weight distribution in the weight bearing(knee, hip, ankle) joints
  • Faulty food habits
  • Insufficient exposure to sunlight
  • Tight clothing
  • Improper footwear
  • Insufficient oxygen supply to the cells due to lack of deep breathing.
  • Accumulation of toxins(harmful substances) at the cellular level due to environmental pollution,fertilizers, pesticides in food and so on.
  • Lack of anti-oxidants in food.

All the above-mentioned factors can cause an acute episode of pain. When such an episode is managed by merely suppressing the pain, without addressing the causative factors, only then it leads to early degeneration and deformities of the joints in the long term. So let’s remember always to “treat the cause and not the symptoms”.



About the author

Bharath Gopinath

physical therapist | musculo- skeletal manipulative therapist | movement rehabilitation specialist | certified yoga and nature cure therapist | professor in physiotherapy | therapeutic natural diet counselor | holistic health enthusiast