When pain doesn’t go away, one of the first questions people understandably ask is: What’s causing it?
Often, the next step is an X-ray, MRI or other imaging study. Imaging can provide incredibly valuable information. It can identify structural changes, injuries and other conditions that may require medical attention.
But anyone who has dealt with chronic pain knows that sometimes the picture isn’t that simple. You can have an MRI showing abnormalities and relatively little pain. You can also experience significant pain and functional limitations without imaging providing one obvious explanation for everything you’re feeling.
That’s because pain is more complicated than a picture of a joint, muscle or spine.
Acute Pain and Chronic Pain Aren’t Always the Same
Acute pain usually has a relatively clear beginning. You twist an ankle. Injure your shoulder. Strain your back. Have surgery.
Pain serves an important purpose in these situations. It’s part of the body’s warning and protection system. As an injury heals, we’d generally expect that pain to improve.
Chronic pain is different. Pain that continues for an extended period can involve multiple factors – including the original injury or condition, changes in movement, ongoing tissue irritation, sensitivity within the nervous system, sleep, stress and the way your body has adapted to protect the painful area.
That doesn’t mean the pain isn’t real. It means finding the best approach may require looking beyond a single test result.
Why Your MRI Still Matters
This doesn’t mean imaging isn’t important. Quite the opposite. An MRI, X-ray or ultrasound can provide important information about what is happening structurally. Depending on the situation, imaging can help identify arthritis, disc changes, tendon injuries, fractures and other abnormalities.
Imaging is one piece of the clinical picture. A provider also needs to understand what you’re experiencing: Where does it hurt? When did it start? What movements make it worse? What makes it better? Has your mobility changed?
What treatments have you already tried? How is the pain affecting your work, sleep, exercise or everyday activities?
Those answers provide information an MRI cannot.
Why Treating the MRI Isn’t Always the Same as Treating the Patient
Two people can have similar imaging findings and very different experiences. One might be golfing, running and living normally. The other may have difficulty walking up the stairs.
That’s one reason we don’t believe treatment decisions should be based on imaging alone.
At Genovations Regen, our goal is to understand both the medical findings and the person sitting in front of us. We want to know not only what hurts, but also what the pain is preventing you from doing.
For one patient, the goal might be getting back onto the golf course. For another, it’s being able to play with grandchildren. Someone else simply wants to get through a workday without constantly thinking about their knee, shoulder or back.
Those goals matter when developing a treatment plan.
Why Pain Can Persist
Persistent pain can have many possible contributors, which is why chronic pain deserves an individualized medical evaluation. Depending on the patient, factors may include an underlying musculoskeletal condition, previous injury, changes in mobility or strength, repetitive stress, altered movement patterns or increased sensitivity of the nervous system.
Sometimes there is one dominant issue. Sometimes several things are happening at once.
Looking Beyond Medication Alone
Medication can play an important role in pain management for many patients. But medication isn’t the only tool available.
Depending on the diagnosis and individual patient, a broader plan might include changes in activity, physical therapy or rehabilitation, strength and mobility work, weight management, medical treatment, injections, non-invasive technologies or referral to another specialist.
At Genovations, we have a particular interest in helping patients explore non-narcotic options when medically appropriate.
That does not mean every patient needs a procedure. And it doesn’t mean surgery or medication should never be considered. Sometimes the most responsible recommendation we can make is that another specialist or another type of treatment is more appropriate.
Start With the Right Question
Instead of simply asking, “What treatment should I get?”, start with: “Why am I still hurting?”
A thoughtful evaluation should consider your history, symptoms, previous treatments, physical function, goals and relevant medical information. Only then does it make sense to discuss treatment options.
Chronic Pain Care at Genovations Regen
If knee, shoulder, back or other musculoskeletal pain is interfering with the things you want to do, you don’t necessarily have to begin by choosing a treatment. Begin with a conversation.
At Genovations Regen, we evaluate each patient individually and discuss appropriate options based on the complete clinical picture.
If you’re dealing with persistent pain and want to better understand your options, schedule a pain consultation with Genovations Regen.
This article is for educational purposes and is not intended to diagnose or treat a medical condition. Persistent, severe or unexplained pain should be evaluated by an appropriate healthcare professional.