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Last updated: Wed, Feb 19, 2025
The relationship between pain and movement was not among the dimensions and flavors of pain that I included in the prior section. It merits some discussion on its own.
One of the first things a care provider will want to know is what movements, activities, and postures seem to increase or decrease your pain. This is a pretty obvious question in common injuries such as strained or sprained joints. In fact, you might begin by telling your doctor that "my ankle hurts" or "my back hurts" or wherever is appropriate. The care provider uses their knowledge of anatomy to focus his diagnosis, and off the two of you go.
In other conditions, the link between "where it hurts" and "what hurts" is not so clear. This was described on the previous page. (Location of Pain.)
The relationship that I want to highlight here, though, is not the fact that activity affects pain, but how much activity affects pain's intensity and its effects. This seems to me to be an important aspect of pain disability and pain stress, but I don't believe I've ever been explicitly asked about it. I assume that care providers develop a sense about this as they talk with their patients, but it's possible that some care providers aren't aware of it or don't find it important.
My own experience is that I can expect increased pain based on the amount of certain activities that I do or don't do. These include sitting up straight, walking, doing my stretches, and others. I can predict how I'll feel in the future based on how I feel when I do those activities and on how long or how vigorously I do them. My predictions are often off. Sometimes I react less to activity than I expect to, sometimes I react more.
The reason I think this is important is that it puts me in a situation in which I must make tradeoffs between the value of activity (that is, the positive things that are available by moving) and the suffering that I expect in the future as a result. It means that there isn't a firm upper bound to how much I can do. I can always choose to do a bit more today in exchange for negative experience at the time or later. Questions that from time to time come from care providers or in social situations, such as "How long can you...?" or "How far can you...?" or "How much can you...?" have no clear answer.
Although I have no experience of it, I can imagine a pain condition that is unaffacted by activity. Perhaps in such a condition, the sufferer, although suffering, wouldn't suffer more if they were active than if they were inactive. Then would there be no motivation to reduce activity? Would the net suffering actually be less than that of a patient whose pain was increased by activity?
I would expect there to be analysis of this situation in the psychological literature as a personal and social problem that most pain sufferers must deal with, but I've run across no such analyses. A number of common beliefs about pain sufferers might be traceable to a lack of awareness of this condition, beliefs that have concrete effects on us. Additional discussion of this question is included in The Challenge of Living in Pain and in Destructive Pain Myths.