Conservation of Pain

Pain is frequently a topic of conversation in physical therapy. Most of my clients do not come to see me unless they are dealing with some sort of painful issue. Conversations tend to center around when the issue will resolve, and what must be done in order to resolve it. Typically, pain is conserved. It improves, and often dissipates with time, vulnerability to that pain persists.

The first law of thermodynamics states that energy in a system is always conserved. Essentially energy cannot be created, nor destroyed. Pain is a similar concept. Pain, like energy, can change form and it is malleable. The body and the brain are also malleable. They store memories so that in the future there is reliable information to fall back on should the same situation arise again. Pain is a memory, a sensation that helps you to remember to avoid the current circumstance if possible.

The conversation around pain is a difficult one. No one knows when it will disappear, nor when it may return. Typically, when a person suffers from an injury, or pain, they become vulnerable to that injury in the future. A dislocated shoulder will forever be prone to dislocate again.

This is actually empowering. Knowing your history and predispositions can help you make informed decisions later down the road. A well-versed health care provider that works with people in pain can help alter the sensation and make it more malleable. Being in pain often involves a rigidity that limits the ability to change form. The memory is there, so that you can in fact alter it in the future.

Austin Ulrich, Physical Therapist