20 Common Myths About Pain
Chronic pain affects millions of people worldwide, yet it's often misunderstood. Misconceptions about pain can lead to confusion, unnecessary anxiety, and treatments that aren't effective. Let's clear up some common misunderstandings about chronic pain, backed by current scientific research.
Myth 1: Poor Posture Causes Chronic Pain
Many people think slouching or having "bad posture" directly leads to chronic pain. However, recent evidence suggests posture isn't a strong predictor of pain (Swain et al., 2020). Everyone's posture varies naturally, and it's usually not the root cause of chronic pain. Posture is largely influenced by genetics, sports, leisure activities and occupation. Many professional athletes and world class performers would fall under the category of “poor posture”.
Myth 2: Core Bracing Prevents Chronic Back Pain
While having a strong core is beneficial, constantly bracing your core isn't necessary or helpful for preventing chronic back pain. In fact, always tightening your muscles can make you more sensitive and tense (Lederman, 2010). Moving naturally and comfortably is usually a better approach.
Myth 3: Structural Abnormalities Guarantee Pain
Findings like disc bulges, spinal degeneration, or arthritis often appear in medical imaging—but they're also commonly found in people without any pain at all (Brinjikji et al., 2015). These structural findings don't reliably predict whether you'll experience chronic pain. A significant percentage of the population have positive findings on MRI of the lumbar spine and the majority are pain free.
Myth 4: Pelvic Tilts Cause Chronic Back Pain
It's common to blame pelvic tilts, such as anterior or posterior tilts, for chronic back pain. Yet studies show little connection between pelvic tilt angles and actual pain (Laird et al., 2014). Variation in pelvic tilt is normal, even among healthy, pain-free individuals.
Myth 5: Pain Always Means Weakness
It's a common belief that chronic pain is directly caused by weak muscles. Strength is certainly helpful for function, but chronic pain rarely comes down to strength alone (Holth et al., 2021). More often, factors like fear of movement and confidence in activity are more important. Improvements in strength do not predict improvements in pain.
Myth 6: Limited Range of Motion Predicts Chronic Pain
Limited flexibility or reduced range of motion (ROM) doesn't automatically lead to chronic pain. Many people with limited ROM experience no pain, while those with chronic pain may have perfectly normal flexibility (Lima et al., 2018). Pain often has more to do with how your nervous system perceives movement than with your actual range. The feeling of stiffness, restriction and guarding in different ranges of motion often leads to pain and discomfort.
Myth 7: Symmetry is Necessary for Pain-Free Movement
We often hear that our bodies should be perfectly symmetrical to avoid pain. But perfect symmetry isn't natural or necessary. Most people have some asymmetry, and it usually doesn't cause pain or injury (Razeghi & Batt, 2002). Think about professional athletes that practice unilateral sports such as baseball pitchers, tennis, kickboxing. All of these individuals will have some level of asymmetry, due to the demands of their sports and are still able to perform at very high levels.
Myth 8: Chronic Pain Means Constant Damage
Chronic pain doesn't always indicate ongoing physical damage or injury. Pain often continues even after tissues have fully healed, driven instead by an overly sensitive nervous system (Moseley & Butler, 2015).
Myth 9: More Rest is Best for Chronic Pain
While rest might feel comforting, too much rest can actually worsen pain and disability. Gradually increasing your activity levels tends to be more helpful, reducing fear of movement and improving overall recovery (Booth et al., 2017).
Myth 10: Chronic Pain is "All in Your Head"
Although emotions and psychological factors do play a role in chronic pain, this doesn't mean it's imaginary. Chronic pain is very real and is influenced by biological, psychological, and social factors all interacting together (Gatchel et al., 2007).
Myth 11: You Need a Precise Diagnosis to Start Recovery
Many people believe that recovery can't begin until a specific tissue or structural diagnosis is found. However, in chronic pain, a clear "cause" is often elusive—and may not even be necessary for improvement. Pain is a multifactorial experience, and addressing nervous system sensitivity, beliefs, and behaviors can lead to progress even without a concrete diagnosis (Moseley, 2003). A diagnosis can sometimes increase fear and promote passive treatment-seeking rather than active recovery.
Myth 12: You Shouldn't Exercise if It Hurts
Avoiding all activity until you're pain-free might sound logical, but it often leads to deconditioning, more fear, and worse outcomes. Safe, graded exposure to movement—even when it involves some discomfort—can reduce sensitivity and build confidence over time (Nijs et al., 2013)
Myth 13: Chronic Pain Is a Life Sentence
Many people are told they'll have to “live with it forever.” But this isn’t true for everyone. Neuroplasticity works both ways—the nervous system can become more sensitive, but it can also rewire itself toward less pain. With the right approach, meaningful recovery is possible, even after years of symptoms (Palsson & Louw, 2020)
Myth 14: You Need Ongoing Manual Therapy to Stay Pain-Free
While manual therapy can offer temporary relief, research suggests its effects are short-term and not superior to active treatments in the long run (Rubinstein et al., 2019). Long-term change typically comes from education, movement, and building self-efficacy—not ongoing passive care.
Myth 15: Pain Is Always Located Where the Problem Is
Pain is often felt in a different area from its origin due to how the nervous system processes signals. Central sensitization and altered brain mapping can create widespread or "mismatched" pain experiences (Flor, 2003). This means chasing pain around the body may not address the real driver
Myth 16: Imaging Should Be Repeated Frequently to Monitor Progress
Repeated MRIs or X-rays often don't provide helpful new information and can even increase fear and medicalization. Imaging findings change little over time and rarely correlate with symptoms (Chou et al., 2009). Clinical progress should be guided more by function, not images
Myth 17: The More Pain You Have, the More Damage There Must Be
In chronic pain, the intensity of pain doesn't always match the severity of any physical issue. Pain is influenced by context, beliefs, emotions, and nervous system sensitivity (Apkarian et al., 2005). This is why some people have severe pain with no clear injury, and others have significant injuries with little or no pain
Myth 18: You Need to Be Pain-Free Before You Return to Work or Life
Waiting for complete pain relief before re-engaging in life often delays recovery. Functional goals—like returning to meaningful activities—can improve pain over time, even if symptoms are still present (Costa et al., 2011). Gradual return to work or life roles is a key part of rehabilitation
Myth 19: Chronic Pain Is a Sign That You're Doing Something Wrong
People often blame themselves for their pain, thinking they’re sitting wrong, moving wrong, or lifting wrong. But there is rarely a single “wrong” way to move. Movement variation is normal and healthy. Excessive fear of doing harm often contributes more to pain than the movement itself (Caneiro et al., 2020)
Myth 20: Chronic Pain Is Rare and Unusual
Chronic pain affects an estimated 1 in 5 adults globally, making it one of the most common health conditions (Goldberg & McGee, 2011). It’s not a niche issue—it’s a public health concern, and awareness is crucial for better care and support
Beyond the Myths: Understanding Your Nervous System
Current research emphasizes chronic pain as complex, influenced by multiple factors like stress, emotions, beliefs, sleep, and overall health. Understanding chronic pain as your nervous system becoming overly sensitive, rather than just structural issues, can empower you to manage your pain more effectively.
Final Thoughts
Clearing up these myths allows you to shift from fear-based thinking to an approach grounded in understanding and empowerment. Movement, confidence-building, and education are powerful tools to reclaim your life from chronic pain.
References
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Booth et al. (2017). "Exercise for chronic musculoskeletal pain: A systematic review." Clinical Rehabilitation.
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Caneiro, J.P. et al. (2020). "Disabling persistent pain: reconceptualising pain and dysfunction in athletes." British Journal of Sports Medicine
Chou, R. et al. (2009). "Imaging strategies for low back pain: systematic review and meta-analysis." The Lancet
Costa, Lda C. et al. (2011). "Prognosis for patients with chronic low back pain: inception cohort study." BMJ
Flor, H. (2003). "Painful memories. Can we train chronic pain patients to ‘forget’ their pain?" EMBO reports
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Goldberg, D.S., & McGee, S.J. (2011). "Pain as a global public health priority." BMC Public Health.
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Laird et al. (2014). "Is There an Association Between Lumbar Spine Alignment and Low Back Pain?" Spine.
Lederman, E. (2010). "The myth of core stability." Journal of Bodywork and Movement Therapies.
Lima et al. (2018). "Range of Motion and Pain Perception in Chronic Low Back Pain." Journal of Pain Research.
Moseley, G.L. (2003). "Unraveling the barriers to reconceptualization of the problem in chronic pain: the actual and perceived ability of patients and health professionals to understand the neurophysiology." The Journal of Pain
Moseley & Butler. (2015). "Explain Pain Supercharged: The Clinician’s Manual."
Nijs, J. et al. (2013). "Pain neuroscience education for chronic musculoskeletal pain: state of the art and application in physical therapy." Manual Therapy
Palsson, T.S., & Louw, A. (2020). "Reconceptualizing pain through pain neuroscience education in adults with chronic pain: a systematic review." Journal of Pain Research
Razeghi & Batt. (2002). "Biomechanical Analysis of the Relationship between Posture and Pain." Journal of Rehabilitation Research & Development.
Rubinstein, S.M. et al. (2019). "Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials." BMJ
Swain et al. (2020). "Is there an association between sitting posture and low back pain? A systematic review." Ergonomics.
