Pain is very common in Australia. 1 in 5 people aged 45 and over are living with persistent and ongoing pain. Pain can be stressful, debilitating and makes it hard for the person to do the day-to-day activities they love. It can affect a person’s ability to work, socialise and exercise.  

Pain is a common and complex condition and can range anywhere from mild to severe. At CSSM, the characteristics we look for are based on how ongoing your pain is and if it is experienced most days of the week. Pain can result from an injury, surgery or musculoskeletal conditions such as arthritis and migraines.  


Pain that is acute or short-term, is a response to damaged tissue and usually disappears once the tissue has healed. Chronic pain is more complex, and may result from damage to body tissue from an acute or chronic condition. It can also relate to changes in the nerves or nervous system that result in the nerves continuing to signal pain even after the original condition has healed. People with chronic pain are generally more likely to experience mental health conditions such as chronic fatigue, depression, sleep interruptions and anxiety.  


Here at CSSM we see and provide treatment for a wide variety of pain including: 

  • Lower back pain  
  • Hip pain 
  • Herniated discs and degenerative disc disease  
  • Arthritic pain  
  • Post-surgical pain  
  • Head, neck and shoulder pain  
  • Thoracic outlet syndrome  
  • Knee pain 
  • Myofascial pain  

Pain can be managed. Pain management should not rely on pharmacological therapy alone. Non-pharmacotherapy options include patient education, physical therapy including soft tissue work, dry needling, cupping, heat or cold packs and a home exercise program.  


How can I distinguish pain?

Pain can be a sign that your red light is on and something in your body isn’t working as it should. Describing your pain can sometimes be the hardest part but this helps the practitioner accurately and thoroughly find the cause of pain to treat it. Writing down information can be helpful. 

  • How long has the pain been around for? 
  • Where is the pain felt? 
  • Does it spread out or is it localised to one area? 
  • Does it come and go? 
  • What makes it worse? 
  • What makes it better? 

Keeping a pain diary can be a good way to track pain levels and triggers as well as seeing if symptoms worsen or change.   


Pain types differ and can be divided into 3 categories relevant to muskuloskeletal pain:

  1. Nociceptive pain (including nociceptive inflammatory pain) 
  1. Neuropathic pain 
  1. Nociplastic pain 

It is not uncommon to have a mixture of pain types. Understanding pain types is important to find the best management plan for you.  


Nociceptive pain

Nociceptive pain represents the sensation of detected tissue injury or damage. Nociceptors are sensory endings on nerves that can be sensitised. Think of how you feel when you jam your finger in a car door, touch the hot plate or stub your big toe. Sometimes, there may be no tissue injury and only pain is experienced in that moment. The pain is signaling an early warning sign helping you to pull away before more damage occurs.  

Once there is some tissue damage, you tend to have an inflammatory response. This is a good thing! Your body responds and starts to heal the damaged tissues. Some other examples of nociceptive pain include a sprained ankle, broken bones or a strained muscle. Signs include swelling, bruising and/or redness. Paracetamol or non-steroidal anti-inflammatories (NSAIDS) may be helpful in managing nociceptive inflammatory pain (post injury) by reducing pain and getting back to being active earlier. Being active faster, but at a steady incline means less stiffness and pain and a quicker return to your daily tasks.  



Neuropathic pain 

Neuropathic pain is pain associated with injury or disease of nerve tissue. People often get this type of pain when they have shingles, sciatica, neck or back radiculopathy. Neuropathic pain is often described as a burning, shooting, stabbing, electric shock, hypersensitivity to touch. When you have neuropathic pain, even a very light touch or gentle movement can be very painful. Early prevention of treatment and medication can play an important role in helping you manage neuropathic pain, especially if the pain is acute and severe.  


Nociplastic pain 

Nociplastic pain is a type of pain that is mechanically different to nociceptive or neuropathic pain. It may work in combination or become generalised. The dysfunction is through the central nervous system (CNS). This type of pain arises with fibromyalgia, tension type headaches, chronic pelvic pain or chronic lower back pain. Recent studies have shown long COVID may also be a contributing factor. This type of pain may reflect changes in the way the nervous and immune systems respond. Other symptoms are common such as fatigue, poor sleep, memory, and low mood. This type of pain does not respond to most medicines and usually requires a tailored program of care that involves addressing factors to ongoing pain (lifestyle, mood, activity, work, social factors).  

All being said, pain is complicated and the degree to which we can challenge it is highly dependent on the individual. If you have been experiencing issues with persistent pain, make sure to get a thorough assessment to get an appropriately tailored plan for your condition. Come on into the clinic and see one of our practitioners to get back on track whether that’s with pilates, gym, a home program or hands on treatment.  


About the author

Myotherapist Adele Agius believes analysing the main components of people’s everyday lifestyles and interests allows her to identify and provide specialised ways to help strengthen, rehabilitate and maintain a healthy lifestyle. Adele enjoys working with people “to help get them back to the activities they love”. 

Adele executes this through a “hands-on approach”, which includes trigger point therapy, dry needling, cupping, myofascial release and treatment of musculoskeletal pain and dysfunction. Adele is a firm believer on educating her clients about their condition and what their recovery process will entail to improve their ability to manage, maintain and overcome their injuries.