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WHAT IS PAIN CYCLE?

The pain cycle is a series of interconnected stages that perpetuate chronic pain and dysfunction in the body. It begins with an injury or acute pain, triggering muscle guarding where muscles tighten to protect the injured area. While initially beneficial, prolonged muscle guarding leads to restricted mobility as muscles and joints stiffen. This causes the muscles to weaken and atrophy, reducing overall function and complicating daily activities.


As muscle weakness persists, decreased function limits normal activities, leading to compensatory movements that cause further issues. The ongoing pain and dysfunction result in emotional and mental stress, such as frustration and depression, which exacerbate the physical symptoms. Understanding each step of this cycle is crucial for identifying how acute pain can turn into long-term issues and for implementing effective interventions to break the cycle and restore normal function.

An illustrated depiction of the pain cycle, showing stages from injury to emotional stress, illustrating how chronic pain perpetuates.
Understanding the Pain Cycle: A Visual Guide to Chronic Pain and Dysfunction

PAIN

When an injury occurs, your body's first alarm is pain. This immediate response serves as a critical warning, alerting you to the need for attention to prevent further damage. Pain acts as a protective mechanism, drawing your awareness to the injured area and signaling you to stop using it. It can vary in intensity and character, from sharp to dull, and constant to intermittent. Understanding this initial stage is crucial as it sets off a series of physiological responses, including muscle guarding and restricted mobility, that can lead to chronic pain if not properly addressed.


MUSCLE GUARDING

When an injury occurs, the same nerves that signal pain also indicate that an injury has happened. In response, your body initiates a protective mechanism known as muscle guarding. This involves the tightening of muscles around the injured area, effectively creating a natural splint to protect the injury. Muscle guarding serves as your body's instinctive response to prevent further damage and promote healing. It acts as a form of self-splinting, stabilizing the injured area to minimize movement and reduce the risk of exacerbating the injury. Understanding muscle guarding is essential as it illustrates the body's innate ability to protect itself in times of distress, highlighting the interconnectedness of pain perception and physiological responses to injury.


A woman sits in an office chair, visibly discomforted by back pain, emphasizing the impact of pain on everyday life.
Enduring Pain: A Woman Struggles with Discomfort

RESTRICTED MOBILITY

In the short term, muscle guarding for protection can be good. For example, imagine you have sprained your wrist. In this situation, the muscles and ligaments in your wrist may be injured. The body's natural response initially is to tighten the muscles around the injured wrist to protect it. This muscle guarding helps prevent further damage to the injured area and aids in the healing process. However, if this condition lasts too long, it becomes detrimental.


When muscle guarding continues for an extended period, it creates restricted mobility in the joints. This means your wrist will not be as flexible or mobile as it used to be. This restricted mobility can persist long after the damaged tissues have healed. For example, weeks or months after injuring your wrist, you might still find it difficult to fully bend or rotate it.


This happens because our body adapts to not using the injured area and related muscles. In other words, because of the pain in your wrist, you avoid moving it, and your body becomes accustomed to not using it. This leads to the muscles and joints losing their normal range of motion. Now, muscle guarding has gone from being a protective mechanism to causing problems itself.


Another example is if you have injured your back. Initially, the muscles in your back will stiffen and tighten to protect the injured area. This muscle guarding is helpful in the early stages of the injury. However, if this stiffness and immobility continue for a long time, the muscles in your back and spine will lose their ability to move normally. It becomes harder to bend, twist, or stretch your back as you normally would. This restricted mobility slows down the healing process and makes everyday activities more difficult. As a result, other parts of your body try to compensate for this immobility, leading to further pain and increased risk of injury.


The restricted mobility caused by muscle guarding, if left untreated, can lead to issues in other muscles and joints. The lack of movement in one part of the body causes other parts to work harder, negatively affecting overall body balance and health. Therefore, it is important to address prolonged muscle guarding and work on restoring normal mobility through proper treatment and rehabilitation.


MUSCLE WEAKNESS AND ATROPHY

Prolonged muscle guarding and restricted mobility can lead to muscle weakness and atrophy, where the muscles shrink in size due to disuse. This phenomenon mirrors the adage "If you don't use it, you lose it." Similar to the effects of sedentary lifestyle on muscle mass, prolonged immobility or reduced use of muscles can result in their deterioration and weakening.


DECREASED FUNCTION

The consequences of prolonged muscle guarding extend to decreased function, representing the next stage in the pain cycle. This decline in function originates from the initial injury and persists throughout the cycle. Ideally, the body's response to injury should involve restoring normal function to prevent the perpetuation of the pain cycle. However, this does not always occur as intended. Decreased function prompts individuals to consciously or unconsciously limit their activities, as the stiff and sore injured area discourages its use.


EMOTIONAL & MENTAL STRESS

Continual pain, muscle guarding, and loss of function can give rise to various emotional stresses, including anger, frustration, depression, and helplessness. Unfortunately, these emotional and mental stresses exacerbate the physical symptoms, increasing overall stress and tension in the body while diminishing motivation. This perpetuates the pain cycle, leading to continued pain and heightened muscle guarding. Left untreated, this cycle becomes a relentless downward spiral, further compounding the individual's suffering and impairing their ability to function normally.

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