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Pain | Rest Or Move?

Should I rest or should I move? Am I causing lasting damage? How do I know what to do and when? These are the most common questions we hear on a daily basis…and very important ones too. Education is one of the most important roles Physios play in ensuring you understand what is causing your pain and why. Empowering you.

Knowledge is power. A simple bit of education on pain and it’s behaviour can be vital to help you notice the signs, act quickly, and return safely.


“The more that you read, the more things you will know. The more that you learn, the more places you’ll go.”

Dr Seuess

Pain

Pain is often defined as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage’. It is a spectrum. From a mild stiffness or dull ache, to a severe stabbing pain or burning sensation. Without going into the complexities, everyone has a different perception of what it is and how bad it is. In this instance we will regard it as a symptom of some underlying problem.

There are 2 main types that we all encounter on a daily basis for different reasons. Inflammatory & mechanical.

Each has distinctive characteristics that can help us to recognise what the best course of action may be to help improve your symptoms, whatever the condition. At The Physios we have vast experience in seeing thousands of patients and treat a variety of conditions. The top 5 being listed below:

  1. Low Back Pain
  2. Knee Pain
  3. Neck Pain
  4. Shoulder Pain
  5. Hip Pain

The information below sets out the differences between the 2, and most importantly what the best treatment may be at that time.


Inflammatory Pain – When To Rest

Inflammation usually occurs due to a chemical irritation when a soft tissue (i.e. muscle/tendon/ligament) has been damaged. Commonly at the start of any injury such as spraining an ankle, straining a muscle, or following the culmination of gradually overloading like a repetitive strain injury. Classic characteristics include pain, swelling, redness and heat. Sometimes you can see these changes like when you graze your knee, or often they can be deep down under skin and muscle.

Inflammation is actually a natural and completely normal response in most instances as it is the catalyst for the start of a healing process. Given the right environment the body is incredibly resilient and will be able to repair these damaged tissues.

Typical characteristics of inflammatory pain include:

  • More moderate to severe pain (more than 3 out of 10 on your pain scale)
  • Constant awareness
  • Easily aggravated and irritable
  • Gets worse the more you move
  • Can take days and even weeks to settle

Inflammation will usually last between 3-10 days if treated well. During this period it is best to offload. Simple principles such as PRICE (Protect, Rest, Ice, Compression, Elevation) may be appropriate. Occasionally alternative interventions such as Acupuncture or over the counter medication can assist in making these symptoms more manageable and aid a timely recovery. Overall a mix of gentle movement and rest is the best way forward. Do NOT push through pain. It will only get worse!

*Inflammation can also occur due to systemic inflammatory conditions such as Rheumatoid Arthritis. Diurnal patterns (i.e. morning and night pain) and episodic flare ups occur due to a more autoimmune response affecting multiple joints and/or body parts. If you do experience these symptoms please consult your Physiotherapist or GP.*


Mechanical Pain – When To Move

Mechanical pain occurs due to some form of mechanical stress on soft tissue like when it is over-stretched or over-compressed. Tiny bits of micro-trauma occur in the tissue fibres that create symptoms such as stiffness, tightness and aches like when being sat for too long behind a desk or over extending to reach for something. It is completely natural, for instance feeling stiff in the morning but can also be the residual symptoms left over when an injury has moved out of it’s inflammatory phase and begins to heal.

Typical characteristics of mechanical pain include:

  • Mild to moderate stiffness or ache (No more than 3 out of 10 on your pain scale)
  • More intermittent. On/off pattern
  • Obvious movements or positions make it worse
  • More you move, the more it improves
  • Eases within minutes or hours

Mechanical pain can be quickly relieved within minutes or hours. During this period it is best to move. Regaining movement and control through mobility exercises, manual therapy, stretching and strengthening will ensure the injured soft tissue heals well.


3 Rules of Pain

If you are experiencing pain then follow these 3 simple rules. You will be less likely to aggravate your symptoms, more likely give you body the chance to heal well, and ensure you do not cause any lasting damage:

  1. 3/10 – if you perceive it to be more than a 3 out of 10 on your pain scale will most likely be causing more damage. If so then STOP!
  2. Increasing – if it begins to increase as you do what you’re doing is likely to be causing more damage. If so then STOP!
  3. Over 24 hours to recover – if it takes longer than 24 hours to recover from what you just did is likely to have caused more damage. If so then STOP!

**If your symptoms have not subsided within 3 weeks despite relative rest then seek advice from your Physiotherapist**

View more articles from Jon Grayson


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