Pain.
Let’s talk about the Voldemort topic in physiotherapy.
I call it the Voldemort topic because, back when I was studying physiotherapy, lecturers often told us not to talk about it — especially with chronic pain patients. Pain “who must not be named” could be a trigger. And honestly? Sometimes it is.
But here’s the problem: most people don’t actually know what pain is, let alone how to deal with it. Pain is often seen as something bad or dangerous — and yes, it can feel that way because its job is survival. It protects us. It warns us when something is off. And for those in chronic pain, that “protection” often feels more like a curse than a gift.
Pain is also communication. It’s your body telling your brain: “Something’s wrong.” That could be a real injury, a potential injury, or a signal from your nervous system saying, “Hey, slow down.” And sometimes, the signal isn’t physical at all. Mental stress, unresolved conflict, or emotional tension can manifest as aches, twinges, or tension in your body — what some call psychosomatic pain.
That doesn’t mean it’s delusion. Not at all. It’s real. It’s there. Your body just doesn’t know how to respond.
I’m fascinated by this perspective. It doesn’t just change how I see pain — it changes how I see people. Pain is never just about the body. It’s about the human experiencing it.
Ignoring pain is like ignoring someone trying to communicate with you. Sometimes you might get lucky and it resolves itself. Often, it doesn’t. Ignoring it doesn’t make it go away — it usually makes it worse.
That’s why I almost always address pain with my patients. Carefully. Sometimes I gauge if they’re ready to talk about it. I choose my words. But I almost always try to explain it, because understanding pain — knowing which signals are urgent, which are not — is essential.
Here’s the hot take: pain rarely has one single cause (unless it’s an acute injury). And it doesn’t need to. Sometimes it’s a learned behavior. Sometimes it’s a warning that once served a purpose but doesn’t anymore. Sometimes it indicates injury, sometimes it doesn’t. Sometimes we can fix it, sometimes we just need to manage it. And that’s okay.
I’m not pain-free 24/7. I’m sometimes pain-free. Sometimes not. What matters is how I deal with it.
Pain medication? It helps — don’t get me wrong. It can improve sleep, movement, confidence, and allow space for healing. But it’s not a fix. Pills reduce perception, not cause. Using them to “ignore” your body is like putting on noise-canceling headphones and walking into traffic — absurd, right? Yet many do this simply because no one ever taught them another way.
Instead, try to understand your pain. Think of it like understanding a newborn or a dog. They can’t talk. You have to interpret signals — crying, whining, pacing. Pain is your body doing the same. You figure out what it needs, when it’s urgent, and when it’s not.
Take my ankle, for example. I’ve had tendinitis in my right ankle since spring — an old injury that never fully healed for long-distance running. Pain comes and goes depending on activity, sleep, and even my cycle. Some runs hurt, others don’t. Some gym sessions trigger it, some don’t. Intensity varies. It never exceeds 3–4/10 and is gone within a day. Progress isn’t linear, but improvement is happening — and that’s a win.
As a physiotherapist, I use the term “irritable” to describe pain. It’s about how easily it can be triggered during daily activities or training: how quickly it appears, how strong it gets, and how long it lingers.
To make this more practical, I’ve put together a simple scoring system. It helps you figure out how irritable your pain is, track patterns, and decide how to respond — whether that means keeping moving, adjusting your activity, or taking a break. Keep in mind, it’s not perfect, but it should give you a hint on how to deal with it.
🧪 Let’s Experiment
Pain is a signal, not a sentence.
This week, instead of ignoring pain or just medicating to “push through,” try observing it. Keep emotions out — just the facts. The goal is to understand how irritable your pain is so you can respond intelligently.
🎯 Try This:
Whenever pain occurs, go through the questions below. Assign points for each answer. Lower points = pain is easy to manage, higher points = pain is sensitive and needs caution.
Total Points & What to Do (Traffic-Light Guidance)
- 9–15 points
🟢 Green: Low irritability → pain is mild and manageable. Keep moving, continue training. - 16–22 points
🟠 Orange: Moderate irritability → monitor carefully. Adjust training, rest more, or reduce intensity. - 23–27 points
🔴 Red: High irritability → pain is sensitive. Reduce load, modify activity, and consult a professional if it persists.
Special Circumstances: Acute trauma, swelling, numbness, or fever? Skip scoring and seek professional assessment immediately.
This content is general information meant to help you understand and guide your approach. It does not replace individual medical advice, diagnosis, or treatment.
🧠 Final Thought:
Pain isn’t the enemy. Understanding it, measuring it, and responding intelligently — that’s real strength. Your body is communicating. Your job is to listen, adapt, and move wisely.
Keep it simple, stay curious, and keep learning—you’ve got this.
Take care,
Carina 🦊
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