Pain Is More Than Where It Hurts: A Whole-Person Approach to Understanding Pain
September is Pain Awareness Month, a time to increase understanding of pain and the experiences of people living with it. And it affects more people than we may realize: approximately 1 in 5 Canadians lives with chronic pain.¹
One of the most important things we can understand about pain is this:
Pain is real. But pain is not always as simple as finding the part that hurts and treating it.
A sore shoulder may involve the muscles and joints of the shoulder. But what if that same person is also sleeping poorly, feeling overwhelmed, afraid to move their arm, naturally very flexible through their joints, or compensating for an old injury?
These factors don't make their pain any less real. They simply tell us more about the person experiencing it.
Pain is an experience, not just a symptom
In 2020, the International Association for the Study of Pain (IASP) updated its definition of pain to:
“An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”²
Importantly, pain is a personal experience that should be respected even when a specific source cannot be identified. It is influenced, to varying degrees, by biological, psychological and social factors.
This represents an important shift away from looking at pain only through a structural lens. It helps explain why two people with similar injuries may experience pain very differently, why pain doesn't always correlate neatly with an X-ray or MRI, and why it can sometimes persist after tissues have healed.
The absence of an identifiable structural cause doesn't make someone's pain any less real.
Sometimes understanding pain requires us to look beyond where it hurts.
When the body has to work harder for stability
Hypermobility is a good example.
Some people naturally have more joint mobility than others. For some, this causes few problems. For others, hypermobility can be associated with recurring injuries, muscle tension, fatigue, joint instability and persistent pain.
As explored in Taming the Zebra: It's Much More Than Hypermobility, caring for people with hypermobility spectrum disorders and Ehlers-Danlos syndromes often requires looking beyond flexible joints.³
When joints have more available movement, muscles may work harder to create stability. Someone can therefore feel "tight" despite being very flexible — and more stretching isn't necessarily what their body needs.
Sometimes the better question is: Do they need more mobility, or more strength, control and confidence within the mobility they already have?
Pain, mental health and the nervous system
Persistent pain can affect sleep, exercise, work, relationships and the activities that make someone feel like themselves. It can contribute to frustration, anxiety, low mood and fear of movement.
The relationship also works in the other direction. Stress, anxiety, poor sleep and feeling overwhelmed can influence the nervous system and our experience of pain.⁴
This does not mean pain is "all in your head." The brain and nervous system are part of the body.
One way to think about the nervous system is as a volume dial. With persistent pain, the system can sometimes become more sensitive. The painful area still matters, but previous experiences, stress, sleep, emotions and expectations can all influence whether that pain volume gets turned up or down.⁵
Whole-person care gives us more than one way to influence that dial. Depending on the individual, this might include hands-on care, better sleep, breathing or relaxation strategies, mental health support, education, strength and gradually returning to meaningful movement.
The goal isn't to keep the nervous system "calm" all the time. It's to help the body become more adaptable.
Movement matters — but the right movement matters too
When something hurts, avoiding movement can feel like the safest response. Sometimes temporarily modifying activity is exactly what an injury needs.
But with persistent pain, prolonged avoidance can reduce strength and capacity and make movement feel increasingly difficult or threatening.⁵ The answer isn't to simply "push through it."
Instead, movement can be gradually rebuilt in a way that is appropriate for the individual.
That might mean walking, strength training, balance work or gradually returning to a sport or activity they love. For someone who is hypermobile, the focus may be less on gaining more range and more on building strength, proprioception and control.
Movement doesn't have to be perfect to be helpful. It needs to be appropriate for the person in front of us.
Looking beyond "Where does it hurt?"
Whole-person care means asking more questions.
How are you sleeping? How much are you moving? Are you under significant stress? Have you stopped doing things you enjoy because you're afraid they'll hurt? Are there hormonal changes, medical conditions or previous injuries that may be relevant?
And perhaps most importantly:
What do you want to be able to do that pain is preventing you from doing?
Sometimes the goal isn't simply reducing a number on a pain scale. It's getting back to gardening, picking up your child, sleeping through the night, returning to the gym or trusting your body again.
This is also where collaborative care can be valuable. One practitioner may address movement and physical capacity, another hands-on care, while others may support sleep, stress, nutrition, hormonal health or the mental and emotional impact of living with pain.
That doesn't mean everyone with pain needs a large healthcare team. It simply means that when pain is complex, care can be broader than treating one painful body part.
At Antidote Wellness Lab, our whole-person philosophy is built around this idea. There may not always be one missing piece. There may instead be several contributors — and if multiple factors can turn the pain volume up, there may also be multiple opportunities to turn it down.
During Pain Awareness Month, perhaps the conversation shouldn't only be:
"Where does it hurt?"
Maybe we also need to ask:
"What might be contributing to your pain — and what does your whole person need in order to move, function and feel more like yourself again?"
Not sure where to start?
When pain involves more than one piece of the puzzle, it isn't always obvious where to begin.
Our Antidote Wellness Concierge can help you explore your individual needs and goals and understand which of our services or practitioners may be the best fit for you.
Book a complimentary 30-minute Wellness Concierge call and let us help you find a place to start.
References
Health Canada. (2022). Health Canada's statement on opioids and pain management. Government of Canada.
International Association for the Study of Pain. (2020). IASP terminology: Definition of pain.
Hakim, A., Keer, R., & Grahame, R. Taming the Zebra: It's Much More Than Hypermobility.
International Association for the Study of Pain. The impact of psychosocial factors on musculoskeletal pain.
International Association for the Study of Pain. Pain, mind, and movement.
This article is intended for general education and is not a substitute for individualized medical assessment or treatment. New, severe, unexplained or changing pain should be discussed with an appropriate healthcare provider.
