addressing the “root cause” of pain

If you’re experiencing pain, there are a lot of questions that need to be answered. One that I get asked a lot, or that I even see PTs talking about answering, is “what is the root cause of my pain?”

Determining the “root cause” is a bit too reductionist, because we know that pain is multifactorial and can be influenced by a ton of different things besides physical factors: sleep, stress, psychosocial factors, nutrition, etc. Sometimes, the source of pain can be pretty cut and dry, but often it’s not that simple.

Regardless, whenever I start working with someone and we dive into the physical aspect of their pain presentation, I’m going to ask a lot of questions to get a clear picture of relevant factors surrounding my client’s pain.

But rather than being hyper-focused on a specific “root cause,” our time is probably better served asking questions about qualities and movement/task demands.

Here’s what that might look like, through the lens of questions I want to answer when evaluating someone.

Do you need tissue strength or length? (or both)

Are you being overloaded or underloaded?

Do you need force production or absorption?

Do you need a different movement quality, or do you need movement quantity? (or both)

Do you need more movement strategies/options, or do we need to improve the quality of your current strategy?

There’s a lot of nuance here (including crossover between questions), and these questions are somewhat simplistic and not necessarily perfect for everyone. But they offer valuable data that can help drive more specific follow-up questions for the person in front of me, and help guide our initial program design. They also shift the focus to activity- and movement-driven care, as opposed to diagnosis-driven care.

If you’re experiencing pain and looking for some guidance in answering these questions, send me an email or book a free call! I’d love to chat with you about your story and see how I can help.