When it comes to pain, most people can relate to this: After about 2-3 weeks of progressively worsening pain, you begin to wonder if it’s something that you need to get checked out. Once you finally fold and head to your Primary Care or a physical medicine practitioner like a chiropractor or physical therapist the thing you want most is to find out WHY that pain is there… WHAT is causing it? To help get your answers imaging may be done: X-Ray, MRI Etc. or orthopedic testing to narrow down where the pain is coming from. Let’s say imaging is done and a report comes back stating you have “disk degeneration.” According to a study by Brinjikji et al., 2015, when assessing pain free populations with MRI’s 52% of 30 year olds and 88% of 60 year olds came back with this finding. Even more so, 30% of 20 year olds and about 40% of pain free 60 year olds showed disc herniations on MRI’s. In other words, while these do cause pain, they may not exactly be causing the pain you’re experiencing, and even if they are there are many other factors to pain that must be considered.

While there are many factors to pain, thinking about 5 “buckets” so to speak can get us on the right track: Biophysical factors (age, activity level, mechanism of injury, injured/inflamed tissue), genetic factors (predispositions, susceptibility to injury, pain threshold), social factors (work demands, sleep quality/quantity, care for dependents, nutritional quality), psychological factors (mechanism of injury, marital and social status, work stress, social support), comorbidities/complications (previous injury, systemic disease, chronic inflammation). All of these play a role in how intense we register pain, and how well we can recover from it.

So, even if what showed up on your imaging is the biophysical cause of pain, that pain has carry over that begins to affect elements of the other four boxes as well. That is why it is always important to address them from a pain management standpoint. Cornerstones to pain management include stress management, breathing exercises, sleep regulation, nutritional/dietary changes and proper exercise prescription.