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Why am I still in pain? Understanding Pain Science

The number one reason why people tend to book an appointment with me is because they are experiencing some sort of pain in their back or neck. For most, it’s a chronic condition, meaning you have either experienced the pain for longer than 6 weeks in the current “episode” or you’ve experienced the same type of pain on and off for years.

First we need to look at and understand what pain is. Here is where it gets tricky - pain is weird. Pain isn’t just a sensation of tissue damage that can be taken at face value, instead it is a complex experience that is 100% controlled by the brain. Therefore, there are many layers involved in understanding your pain specifically because our brains are tricky organs. They don’t just rely on current information (i.e. a strained muscle) they are receiving but rather they develop what you feel now from a combination of past experiences and future expectations. Ever wonder why “that old injury” always seems to resurface?

One of the big issues I see in practice today is our extreme aversion to pain. Everything around us promotes a culture of masking and covering pain which dilutes our body’s ability to navigate the reasons you are experience pain in the first place. Have a headache? Take a Tylenol. Joint pain? Take an Advil Joint Pain. Sore back? Take a Robaxacet. We are so far removed from actually figuring out and understanding what is going on in our bodies and how we can fix it.


Moreover, we need to STOP thinking of pain as a singular cause that has a singular cure. This is where I think a lot of practitioners stray in a reductionist view that leads to trying to answer a complex question (“why am I in pain”) with a simple answer. For example: “Your knee pain is coming from a tight IT band.” Although this may be contributing to your experience of pain, the problem is it rarely ever the only problem. Our bodies are just far more complex than that. At the very least, since pain comes from the brain, there is an added layer of brain-generated complexity to that “tight IT band.” At the very worst, your pain system can malfunction causing a host of other problems and experiences which can prolong recovery.

So, if pain isn’t a reliable source of what is actually happening in my body, where do I go from here?


  1. Treat the Underlying Cause. This is really what I focus on and repeatedly talk about when in the office. Pain is often collateral damage to an underlying or core problem. Figuring out what this is can be difficult, especially since there are often many contributing factors. Developing a plan with a health professional who understands these connections is vital.

  2. Give your body time. As I said previous, many of us are so disconnected with our bodies and have been taught most of our lives to ignore pain ad other body signals until they become too big of a problem that you HAVE to do something about it. Most chronic pain and injuries have taken years and years of abuse and damage to get to where they are today so we can’t expect our body to heal over night. This is especially true with back and neck pain.

  3. Change your Environment. Most injuries in our bodies are a consequence of repetitive forces from the environment WE put ourselves in. Whether this is sitting a desk all day or participating in sport - we are the own creators of what happens to our bodies because of our environment. If we are not constantly changing things in our day-to-day lives we will always experience the same results in terms of pain and health. “Insanity is doing the same thing, over and over again, but expecting different results.” - Albert Einstein

  4. Practice Positive Movement. What do I mean by positive movement? A scientist by the name of Todd Hargrove came up with this: moving as if you are more comfortable then you actually are as a way to build up your confidence with whatever movement you can reasonably handle. Move in ways that are as pleasant, fun and inspiring as possible. Pain limits movement so push against those limits gently, creatively and playfully.

  5. Think away the pain. I say this with all honesty and as silly as it may sound, our brains are the creators of pain and are therefore self fulfilling prophecies. Too often we think our body’s are against us; they are breaking down because we are getting older; this injury is never going to heal; and the list of negative self talk goes on and on. Think of the abuse we put our bodies through (myself included) and how resilient they actually are. We are DESIGNED to heal, adapt and express health. It all starts in the brain - you have to think it, believe it and practice it every day. Create the environment in your mind and in your thoughts for your body to heal and watch how powerful you actually are.

Let us give back the respect to our bodies that they deserve. We truly are incredible beings that are capable of so much. Our body will always chose the path of least resistance and what it is comfortable in - don’t let this be pain and dysfunction. Work every day on creating health in your body and using the power of your mind and thinking to achieve the results you want.


Dr. Alfredo is a health enthusiast who’s goal is to help people and families live healthier, happier lives. My philosophy on health is simple - our body’s have the amazing ability and potential to self-adapt, self-regulate and THRIVE in this world.

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