“Pain Equals Damage” | Busting Movement & Pain Myths | Series with Dr. DePalma and Dr. Camoratto

by | Dec 30, 2018 | 0 comments

Traditionally, the Biomechanical Model was referred to when dealing with patients in pain. The Biomechanical Model is the practice of treating pain as the equivalent of mechanical dysfunction.

We now use the BPS model, or Biological, Physiological, and Social model when treating patients with pain because we now know that pain has biological, physiological and social aspects. There is a large portion of the population that have some sort of degeneration or change in their structure, be it their spine, shoulder, knee, etc. and do not have any symptoms at all. This should be a clear indicator that there is a disconnect between structural abnormalities and pain perception.

Patients are constantly asking for either an MRI or X-ray imaging in hopes of figuring out what is happening with their body, thinking that it will be like opening up a window in their skin with a big red flag indicating what is broken, torn, inflamed or causing their pain. An image may show some structural change or “damage” that could be there but that does not explain why you are in pain. Pain does not equal damage.

There are physical reasons for pain but the brain can perpetuate and increase the perception of pain through fear avoidance. Pain is a protection mechanism that once perpetuated or perceived to be worse it is an inappropriate response, creating a snowball effect. Even everyday stress from life can increase our pain.

We have evidence on the patient outcomes of those who hav seen their imaging and those who have not. Unfortunately, those who have seen their imaging generally have higher pain perception, longer stints of disability and more medical bills than those who did not see their imaging.

It is very unlikely that if you feel pain suddenly, degeneration is the cause. Most likely you have endured an acute injury. Degeneration or structural changes are commonly seen in imaging but again, a large portion of the population has these structural changes without any symptoms at all. These changes are similar to getting wrinkles and we know they get worse as we age but we know they are not harming us.

The Movement Dr. is here to educate, empower, create independence and resilience so that you can live pain-free!

If you are in chronic pain, you are most likely dealing with some level of pain perpetuation or increased pain perception. Get in touch with me today so we can work together to get your pain-free life back.

If you are dealing with acute pain from an injury before you get that MRI or X-Ray, contact me and I will be happy to discuss your options with you.

Interested in learning more about common movement and pain myths? Check out all of these myths.


Webster et al. Iatrogenic Consequences of Early Magnetic Resonance Imaging in Acute, Work-Related, Disabling Low Back Pain. 2013.
Brinjikji et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. 2015.

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