Why Pain is The Worst Reason to Have Physical Therapy

How to maximize function to get the most out of life

Lilian Holm
5 min readOct 21, 2020

Photography: Oliver Sjöström

Musculoskeletal health is your ability to walk, run, exercise, shop, take care of both your family and your house, spend time on your hobbies, travel, work, sail, dance, walk your dog, make love and move in a way that maintains the health of your other body systems, such as your cardiovascular system and brain. For something this vital to our health and happiness, we have a surprisingly unclear idea of how to take good care of it, and often tend to take notice only when struck by a sudden or nagging pain or ache. Even when we feel pain, many of us employ strategies like blocking pain with medications, “toughing it out” and telling ourselves that things will get better on their own instead of finding out what it is that is amiss.

Physical therapists are the experts of the evaluation and treatment of this system, and our patients tend to seek our help when the musculoskeletal system signals trouble through pain. Pain, while most certainly a sensation that gets our attention is, unfortunately, a surprisingly unreliable measure of health, and therefore cannot be used as a gauge of whether there is a problem that requires our attention or not. Because of this, when it comes to something like dental health, most people rely on regular checkups instead of waiting for a searing toothache to tell them something is wrong. Likewise, when it comes to cardiovascular health, we accept that hypertension or arterial calcification happens quietly, without any outward manifestations or subjectively observable signs, and we certainly don’t stop taking statins and blood pressure medication because we don’t notice any symptoms. Why, then, do we seek the help and guidance of a physical therapist only when we feel pain, and why does the average patient stop attending physical therapy as soon as pain disappears?

One reason is probably the fact that physical therapy in the United States used to be something patients were funneled to through physician referrals, and when one discipline is trying guess what another discipline can evaluate and treat, and what the treatment should be and how long it should take, mistakes are bound to happen, and they did. Today insurers no longer require a referral from a medical doctor for patients to see a doctor of physical therapy, and most states have one form or another of direct access , but old habits die hard and physical therapy is sought by many as a form of pain relief. It is not unusual for a physical therapist to hear a patient say “I think I won’t come today, I’m not in that much pain”. And that, dear reader, is a big mistake that leads to the loss of the opportunity to maximize your health and well-being, improve both athletic and everyday performance, and prevent both acute injuries and gradual decline through “wear and tear”, and guard against gradual loss of function.

Musculoskeletal injuries are among the greatest contributors to healthcare expenses in the US — the cost us the equivalent of 5.76% of the national gross domestic product (GDP) — and are therefore one of the health problems you are most likely to suffer from. One in three adults suffers from chronic musculoskeletal pain, and the greatest proportion of persistent pain conditions is caused by musculoskeletal conditions. According to the WHO musculoskeletal conditions are commonly linked with depression, and increase the risk of developing other chronic health conditions.

You are likely to have several imperfections in the functioning of your musculoskeletal system that act as “irritants” that may gradually, over time, contribute to wear and tear, or constitute risk factors that make an acute injury much more likely.

Identifying and correcting these imperfections can help prevent unnecessary pain and suffering by bypassing the traditional activity-injury-rehabilitation-activity loop that isn’t much fun to begin with, and is a likely contributor to the early loss of full function.

And, as if not being able to move freely and in a way that we enjoy weren’t hard enough, with loss of movement all body systems suffer. Modern life, while great in so many ways, is unfortunately also very hard on our bodies, and the study of this phenomenon has led to the mismatch theory. Our teeth suffer from cavities, our bodies from obesity and elevated blood sugar, and while humans seem to have been predisposed to cardiovascular disease for a long time our current lifestyle most certainly increases our risk. But while we seek to mitigate this threat to our teeth, hearts and blood vessels through the use of modern technology, regular checkups and preventative care, our musculoskeletal system withers away, misunderstood and neglected, unable to contribute positively to our ultimate healthspan.

Arguably, the much better choice is to elevate our musculoskeletal system from its undeserved step-child status and finally give it the attention and love it deserves, and use physical therapy to its fullest extent, long before our muscles, joints and physical function suffer irreversible damage.

Regular physical therapy check-ups can catch and correct problems long before they make themselves known through pain. You can also stay in touch with the status of your musculoskeletal system through a self-administered test that can alert you to potential problems, and contact your physical therapist when the result of the test alerts you to a potential risk factor.. Using physical therapy services, before pain forces you to, can also result in a better golf swing, better stamina during your next vacation or visit with grandchildren, or help shave a minute off your 5K, and that’s more than you can say about your regular visits with your dentist (sorry, dentists!) or the cholesterol-lowering medication you take.

So if you’re in acute pain, have sprained an ankle, pulled a hamstring, hurt your shoulder or suffer from chronic back or neck pain, do seek physical therapy ASAP. But once you recover, don’t wait until the next time you’re in pain. Make friends with your body, take good care of it, and make regular preventative care part of your health maintenance approach.

And when your friends complain about the activities they can longer participate in and you don’t have to — you’re welcome!

About the author: Lilian Holm, PT, DPT is a doctor of physical therapy in private practice in Evanston, IL. She specializes in orthopedic and chronic pain conditions and hypermobility disorders. She is passionate about maximizing your health and function. She can be found at https://www.lilianholm.com/ as well as on social media.



Lilian Holm

Lilian Holm, PT, DPT is a physical therapist in private practice in Evanston, IL. Find her at https://www.lilianholm.com/ and on social media.