Pain is the Fire Alarm, Not the Fire

Imagine this with me. You are sitting in your living room, and to your left a fire starts raging up the curtains. It’s no more than 10 feet from you, and you can feel the heat on your face. The heat stings your eyes, so you wince and look away. Every second it grows bigger and bigger. Now the flames are touching the ceiling, and smoke is billowing upwards filling the top of the room. A loud sound to your right pierces the air. The fire alarm begins blaring. It’s painfully loud. 

What do you do? Do you go to the fire alarm and start fanning it to get it to shut off the noise? Do you get a chair and take out the batteries? Do you get a pillow and muffle the sound of the fire alarm? 

Obviously not, this line of action is patently absurd. 

This is a wonderful illustration of the best way to understand and treat chronic muscle and joint pain. The fire alarm is the pain signals your body is generating to alert you to an underlying problem. The fire is the underlying root cause of the pain signals called pain generators. Most long-standing muscle and joint pain problems have 15-30 separate pain generators, all contributing to the cumulative experience of your pain. 

These pain generators can be organized into four categories: 

1. Biomechanical problems 

2. Structural problems

3. Inflammatory problems 

4. Nervous system problems 

We covered what’s included in these four categories in the blog post, Joint pain is a complex, worsening problem. 

The big idea is this. In order to get out of pain for good, you must put out the fires, not try to silence the fire alarm. Unfortunately, many of the treatments recommended to us are aimed at silencing the fire alarm, not finding and putting out the fire. They are aimed at treating symptoms, not finding and fixing the root cause pain generators. 

Some examples of symptom-chasing treatments include cortisone injections, pain relievers, anti-inflammatories, some surgeries, ice, heat, massage, chiropractic, and rest. However, there is a time and place for each of these treatment options. 

So how do you know if it’s just treating symptoms or getting to the root of your problems? Here are two ways of thinking about this question. 

• Framework #1: Does it fix my pain for good or merely decrease the symptoms for a period of time? If it just decreases symptoms for a period of time and doesn’t fix the problem for good, it’s just treating symptoms. 

• Framework #2: What problem is this treatment going to fix? If it isn’t aimed at anything other than decreasing your pain, it’s just treating symptoms and not fixing your pain generators. 

A Hidden Cost

What’s the problem with decreasing symptoms for a little bit? At least it helps with the pain for a time. 

There is an enormous hidden cost associated with this line of thinking. By only treating the symptoms, you are covering up and ignoring the problem your body is trying to alert you to. By covering up and ignoring the underlying problem, you give it time to worsen and multiply itself into more and more problems. 

Here’s an example: you start having back pain caused by a simple weakness problem in your glute medius muscle on one side. Rather than investigating what your pain is trying to alert you to, you take some Advil or get a cortisone injection and keep on living. That glute medius weakness creates focused areas of load and misalignments into your lower back, knees, and feet. You ignore the pain and the real problem for years. Soon you can’t ignore it any longer. You feel like you are “falling apart”. Over the next couple of years, you are shocked to find out that you have degenerative problems in your spine, knees, and feet. You are now facing back surgery, a knee replacement, and cortisone injections in your foot. You chalk it up to genetics or bad luck. In reality, your body has been sending you early warning signals about the underlying problems for years. 

This is the problem with symptom-chasing treatments. They are a distraction away from the root cause problem your body is trying to alert you to. The price you pay for symptom-chasing treatments isn’t just the dollars and pain of the procedure itself. It is the ongoing destruction of the interdependent joints above and below the root cause problem.

The Lesson

If you never treat the root cause pain generator, you will never get out of pain for good. If you want to get out of pain for good, find and fix the root cause pain generators your body is trying to alert you to.

Author Matthew Lister
CEO & Founder of Align