We often hear physiotherapists refer to the pain cycle, but what exactly do they mean?
Understand the pain cycle
After an injury, we are in pain and fearful of moving, afraid that this might make the pain or injury worse. Overtime, If we continue to avoid movements, this behavior may create a continuous cycle of negativity referred to as “the pain cycle”
When an injury happens, an individual will first feel an increase amount of pain. Our brain responds to the pain signal by protecting all muscles around the injured area, causing them to spasm and restrict movements in order to avoid further injury (guarding).
This protective mechanism may become negative to our healing process if it persists past the time that the tissues have repaired and may cause muscle weakness and atrophy long-term. As a result, there is decreased function, which may lead to increase stress and feelings of frustration, decreased motivation and more pain.
To illustrate this cycle, we can imagine an individual who has sustained an ankle sprain. Fearful of movement and increased pain, the individual limps in order to avoid using it. However, the avoidance behavior continues for several weeks to months. Not only does the patient develop pain at the knees, hips and back from limping but it also causes muscle weakness and atrophy at the calves and ankles long-term, limiting his functional activities and affecting his overall quality of life.
How to break the pain cycle
It is important to break this cycle as soon as possible! A physical therapist will allow you to better understand pain, use passive techniques to reduce pain and increase movement and gradually introduce active techniques such as exercises
As the individual starts to increase movement, range and strength increase and overall function as well. This creates less physiological stress and less pain which inhibits the muscle guarding creating a positive cycle!
References:
Brainworks. Contain Your Pain: Breaking the Pain Cycle. (2010). Retrieved from https://brainworksrehab.com/contain-your-pain-breaking-the-pain-cycle/, on September 19, 2019.
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We are physiotherapists passionate about movement and rehabilitation, with a clear goal: helping people better understand their pain and return to an active, unrestricted life.
Through our practice and content, we share practical, science-based approaches to prevent injuries, relieve pain, and sustainably improve mobility. We believe that well-informed patients make better decisions and achieve better outcomes.
Richard Bouzaglou, B.Sc. PT
Physiotherapist | Co-Founder
An experienced professional, Richard is the co-founder of the AMS Medical and Rehabilitation Center, where he has played a key role since 2008. With a background in sports medicine and physiotherapy, he has developed strong clinical expertise, particularly working with elite athletes.
His practice is based on a comprehensive approach that integrates advanced manual therapy, functional rehabilitation, and personalized care. Committed to continuous education and mentoring students, he is known for his clinical rigor and his ability to build lasting, trust-based relationships with his patients.
Moshe Vazana
Physiotherapist
With over 15 years of experience, Moshe is recognized for his precise, evidence-based approach. A physiotherapy graduate with advanced training in several methodologies, including the McKenzie Method (MDT) and the Mulligan Concept, he specializes in treating musculoskeletal and spinal conditions.
His international background and commitment to excellence enable him to provide care that is tailored, effective, and sustainable. Passionate about knowledge sharing, he is also actively involved in training the next generation of physiotherapy professionals.
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