When managing pain, there is no magic bullet (we all wish there was!). What helps one person may not help you. If what was recommended in the past has not worked for you, you’re not a “lost cause” or “hopeless” and it probably means that you haven’t actually tried “everything in the book,” (a common answer to get that friend/relative from sharing advice you didn’t ask for).

We’ve all received unsolicited advice from friends and family members; and if you’ve been experiencing pain for some time, you’ve probably heard it more than others: “I had a crick in my neck a few months ago, my doctor told me to do x, y, and z and it worked. Maybe it could help you too!”

There are a lot of misunderstandings about our conception of pain versus our lived experience.

Science shows that there are multiple mechanisms within us - it’s not about finding “the best” technique. It’s about learning what works best for you (we’re not trying to jam a square peg in a round hole).

Seeking treatment at the start can seem frustrating - maybe the exercises aren’t working, maybe the hands-on manipulation is causing *more* pain, and you’re thinking “this is supposed to make me feel better why is it not working?!” Who *you* are as a person and what *your* experience of pain is on an individual level means that your route to feeling better will likely take a few different attempts for you to try things out and collaborate with your physical therapist to find what works for you and what helps you to start feeling better.

The goal of physical therapy is not only about instant relief, but about rediscovering how your movement allows you to move better and with less pain. The goal of any therapy is to get your life back and allow you to do the things you love without worrying about your pain alarms ringing.

It’s easy to think about pain like a light switch: your brain flicks it on or off depending on sensory information and past experiences, but pain is like a dimmer switch. The amount of pain that you have is not related to your tissue health, healing from pain starts in reframing your experience, perceptions, and fears around that pain and understanding it’s a multifaceted journey.

Remember that everything is always changing. You might forget this if you feel like you’ve been “stuck” for a while, but finding the right help to provide some lubricant to the cogs can help get things spinning again.

This activity is adopted from an approach by Dr. David Butler and Dr. Lorimer Moseley. Let’s begin by defining some terms:

- A ‘danger in me’ or DIM is anything that makes you feel unhealthy, unsafe, weak, angry, irritated, sad, scared, nervous, etc. 

- A ‘safety in me’ or SIM is anything that makes you feel the opposite, happy, strong, healthy, safe, empowered, calm, relaxed, etc. 

Use the categories listed in the image below to help guide your reflection. Ready? Set? Go!

Once you’ve reflected on this list, check to see if your DIMs outweigh your SIMs. If they do, this is a sign there’s going to be protection and pain is one of those outputs of protection.

Neil Pearson is a physiotherapist and Clinical Assistant Professor at the University of British Columbia. He is a yoga teacher, a yoga therapist, and creator of the Pain Care Yoga training programs for health professionals and yoga therapists. Neil is founding chair of the Physiotherapy Pain Science Division in Canada, recipient of the Canadian Pain Society's Excellence in Interprofessional Pain Education award, faculty in yoga therapist training programs and an author. Neil develops innovative resources, collaborates in research and offers a yearly mentorship program for health professionals and yoga practitioners seeking to enhance their therapeutic expertise. He is co-editor of ‘Yoga and Science in Pain Care: Treating the Person in Pain,’ and ‘Understand Pain Live Well Again’. You can find great resources at his website www.paincareu.com and the first 5 steps in The Pain Care For Life program are FREE at: www.lifeisnow.ca

This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.