Does Pain Always Imply Harm? – Howard J. Luks, MD

Every Pain Doesn’t Mean Harm: Understanding Discomfort and Movement

Pain is a natural signal from the body, but not every ache or discomfort we feel is a sign of harm. In fact, many types of joint pain or muscle soreness are part of the normal human experience, especially as we age or engage in physical activity. Understanding when pain is a cause for concern and when it’s simply a normal part of movement is crucial for maintaining a healthy, active lifestyle.

Our Bodies Are Built to Move

Our bodies have been engineered to move through hundreds of thousands of years of evolution. Our muscles, joints, and metabolic systems are designed to thrive with regular activity. Movement stimulates blood flow, oxygen delivery, and nutrient distribution, all vital for maintaining healthy tissues. It’s important to remember that while some pain may accompany physical activity, the long-term benefits of movement far outweigh the risks of being still.

• Metabolism and Repair Processes: Movement activates key metabolic processes that improve overall health. Physical activity helps reduce inflammation, stimulates endorphin release, and activates repair processes. In some instances, exercise can promote healing, as movement increases circulation and helps transport nutrients and oxygen to tissues needing repair.
• Exercise Is a Signal for Repair: When we exercise, we engage not just our muscles but also our body’s repair mechanisms. Cells responsible for tissue repair, such as fibroblasts and stem cells, are activated through regular movement and exercise. When we’re still, these processes slow down, increasing the risk of stiffness, injury, and degeneration.
• Many chemicals released during exercise stimulate growth, repair, and more. These include lactate, myokines, exerkines, and others.

Pain Doesn’t Always Mean Damage

It’s natural to experience discomfort or soreness when using muscles and joints, particularly after long periods of inactivity or engaging in unfamiliar activities. This type of pain doesn’t necessarily mean that damage is being done.

• Soreness vs. Harm: Most soreness is simply a signal that your body is adapting to activity, such as the delayed onset muscle soreness (DOMS) that many experience after exercise. While it can be uncomfortable, it’s not harmful. The challenge is recognizing when pain is an indication of an injury or more serious problem versus when it’s a normal response to movement.

The Risks of Inactivity

The real risk lies in being sedentary. A lack of movement weakens muscles, stiffens joints, and can lead to accelerated progression of degenerative conditions such as osteoarthritis. Yes, osteoarthritis will often progress more rapidly in people who are sedentary. The modern sedentary lifestyle, with prolonged sitting or inactivity, is linked to higher risks of obesity, cardiovascular disease, and even early mortality. Movement, on the other hand, is the key to longevity and vitality.

• Sedentary Lifestyle Risks: Remaining still for long periods puts your body at greater risk of chronic conditions like heart disease, metabolic syndrome, and joint stiffness. The inactivity also limits the release of natural anti-inflammatory agents produced by muscles during exercise, making chronic pain and injury more likely.

When to Be Concerned About Pain

Of course, not all pain should be ignored. Certain signs indicate a more serious issue, such as sharp, sudden pain, pain that limits one’s ability to move, or pain that worsens over time. This is where healthcare professionals, like sports physicians, come in.

Most patients who visit sports physicians are understandably concerned that their pain is a sign of worsening injury or long-term damage. However, in many cases, patients need reassurance and guidance. With a thorough examination and understanding of their pain, we can help them differentiate between discomfort that’s okay to push through and pain that requires intervention.

The Role of Sports Physicians

As sports physicians, our role is to listen carefully to patients’ concerns, evaluate their pain, and guide them on how to remain active safely. Often, patients simply need someone to validate their concerns and help them understand that exercising with some discomfort is okay. In most cases, discomfort from movement is not harmful and doesn’t mean that the underlying condition is getting worse.

By staying active under professional guidance, patients can continue to reap the benefits of movement, improving both their mental and physical health without fear.

While pain can be intimidating, it’s important to recognize that not all pain means harm. Our bodies are designed to move, and the benefits of regular activity are undeniable. Understanding the difference between discomfort and real injury is key to staying healthy and active. And when in doubt, healthcare professionals are here to provide the clarity and confidence you need to keep moving forward.