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There is good pain and there is bad pain – Ogden Clinic provided source, Standard-Examiner 9/1/2015

OGDEN – Pain is the body’s way of telling you something’s not right, so why do we always hear the term “No pain, no gain?” Is there such a thing as good pain and bad pain?

Believe it or not, the answer is yes.

Pain is necessary for our survival. The pain you feel when you step on a nail and withdraw your foot to avoid further damage should be viewed as good pain because the warning system worked, said Dr. Nathan Savage, a physical therapist at Total Rehab Inc., in Ogden.

“That being said, certain kinds of pain, such as that being experienced after a good workout or a new exercise routine is often called good pain because of the context in which the pain was produced,” Savage said. “Ultimately, pain is produced by your brain when your brain perceives any stimuli as threatening, including stimuli that are causing injury or harm.”

Nathan Goff, a physical therapist at Ogden Clinic, also said there are times that pain is a symptom of something good that is happening.

“For example, we have all had pain from a good work out. That pain is a symptom of tissue repairing and muscles being stretched or strengthened. It usually resolves in about 72 hours,” Goff said. “Other times that it’s OK to have pain is when you are trying to normalize the length of tissue. For example, and those of you with total knee replacements will understand, stretching a joint after surgery to regain range of motion and function is always painful, but necessary to achieve the goal of normal function with that joint.”

Good or bad, pain should never be ignored, said Savage. Pain that occurs at night, doesn’t change with movement or position or does not respond to medication should be a concern that something more serious could be happening. In addition, sharp pain, pain associated with swelling, constant or worsening pain, pain coupled with bruising, fever or chills and pain that is so severe it causes nausea or vomiting should be examined by a health care provider.

“We should never ignore pain that is persistent and unrelenting. The body’s way of alerting us that something is wrong is through pain,” Goff said. “If it doesn’t resolve, or if you are unable to get into a position that reduces that pain, it’s probably time to see your doctor and rule out a more serious problem.”

Pain can also become chronic. The National Institutes of Health reports as many as 100 million Americans suffer from some form of chronic pain, costing the country an estimated $600 billion annually.

Chronic pain is defined as pain that lasts for several months or years and in many instances, the pain is ongoing or unresolved.

“Research into chronic pain has revealed some very interesting information and treatment approaches. One of the most effective strategies to treat chronic pain is called Therapeutic Neuroscience Education,” Savage said. “This is typically an approach guided by a physical therapist or other pain specialist to educate patients about their pain and helps provide specific treatment recommendations to reduce or eliminate their chronic pain.”

The approach, Savage said, utilizes education and what is known as Graded Motor Imagery in an effort to help patients reorganize their nervous system and change how their body experiences and processes pain information.

“All of these approaches encourage regular physical activity, being careful not to aggravate their condition, and to gradually increase their level of activity over time in order to restore function and improve their quality of life,” Savage said.

Goff said some examples of chronic pain include headaches, low back pain and nerve pain. Not only can it affect a person physically, but emotional changes such as depression, anxiety and fear of returning to normal activities can also occur.

“Some chronic pain comes from disease processes that have no cure so we can’t always eliminate pain, but we have found that addressing pain early is helpful,” Goff said. “We also know that keeping healthy weight and gaining and maintaining both good mobility and good strong muscles is helpful in controlling pain.”

And we need to allow our bodies to recover, Goff said.

“People who go to the gym on a regular basis know this. They mix up their work outs to allow certain muscle groups to rest. If we persistently do the same thing every time the work out pain turns into injury which then can become a chronic problem,” he said. “We see this more often now in younger people because there is such a push to specialize in sports. Gone are the days of seasonal sports. Soccer, baseball and dance have become year round activities. As a result we see more and more injuries and chronic issues.”

While medication has a role in the management of pain, both therapist’s encourage people to fist try conservative measures such as heat, ice, rest, therapy and exercise.