"When to Not Ignore the Pain"

John P. Bradley, PT

Okay, the shoulder has been hurting for about a month now, and you have tried everything. Heat has been recommended by dozens of friends, and it has provided only temporary relief. An equal number of friends and family have vigorously refuted the use of heat and swear by ice, but it too has not really helped. You are on a first name basis with everyone at the drugstore from repeated trips to purchase everything from over the counter pain relievers to a seemingly endless array of salves, rubs, ointments and supposedly miracle products to apply topically for pain. The next step is to resurrect grandma's book of home remedies and try to find the cure for this nagging pain. Sound familiar?

As a physical therapist, I hear similar stories from patients everyday. Most of my patients do not run to their doctor or therapist at the first sign of an ache or pain. Human nature being what it is, we all tend to "wait things out". Certainly, most of us age 40 or older wake most mornings with more than a few uncomfortable areas, and we often ignore them, accepting this phenomenon as normal. So when should you not ignore an ache or pain?

Without hesitation, following any type of accident, trauma or sudden injury, you should seek immediate medical attention. As obvious as this seems, I have countless histories from patients who delayed medical intervention following a serious injury, ultimately complicating their recovery and eventual outcome. But what about that pain or soreness that just seemed to gradually develop? First, try to remember when this actually started and what may have coincided with it. Did you start a new exercise or sport? Was there some different physical activity at home or work? (I am always inundated with back, shoulder and leg strains with the start of gardening season!). It is often normal to have muscle or joint soreness with new or more vigorous activity, and this is often referred to as "delayed onset muscle soreness". But this soreness should resolve in 2 to 3 days with resting the affected body part and light stretching. The point here is to pay attention to your body and take notice at the first signal of discomfort. Pain that does not get better in a few days after the new activity deserves to be evaluated by your physician.

If your pain is affecting the way you function everyday, do not ignore it. What may start as knee pain with walking or climbing stairs everyday could lead to back or hip pain from limping or compensating with your body. Now you have pain in multiple areas versus one.

Chronic but mild pain in any area of the body that does not seem to change no matter what you do needs definite attention. What you may feel as muscle pain in your back that you have had for months could be coming from several other areas not even related to your spine.

Pain is a very touchy subject. One person's pain may simply be another person's sense of stiffness or soreness. Tolerance to pain varies tremendously. With so much uncertainty about interpreting pain on your own, why take chances? See your physician to be sure if your pain is normal for your current situation or if you need more evaluation to find its source.