Why Pain Can Show Up Without a Clear Injury

By Dr. Andrew Kakishita, DC

A Common Question I Hear

A lot of people come in asking the same thing.

“I did not hurt myself. Why does this hurt?”

This is a very reasonable question. Pain is often associated with injury, but the two are not always the same.

Pain Is Not Always About Damage

Pain is the body’s way of protecting itself. It is influenced by tissues, nerves, stress levels, sleep, and past experiences.

Sometimes pain shows up because tissues are overloaded or sensitive, not because they are damaged. Other times, the nervous system is simply more reactive than usual.

This does not make the pain less real. It helps explain why imaging can look normal while pain is still present.

How Load Builds Over Time

Many pain issues develop gradually.

Long workdays, repetitive tasks, reduced movement, or sudden increases in activity all add stress to the body. When recovery does not keep up, pain can appear without a single clear moment of injury.

This is common with foot pain, back pain, and shoulder pain.

Why Pain Can Feel Confusing

Pain without injury often feels unpredictable.

It may come and go. It may move around. It may feel worse at certain times of day. These patterns can be frustrating, but they are common when pain is related to sensitivity rather than damage.

How Care Is Approached

When pain shows up without injury, care focuses on restoring tolerance.

This includes movement, strength, and addressing contributing factors like stress and sleep. In some cases, tools like shockwave therapy are helpful. Research shows shockwave therapy can support tissue healing and improve load tolerance when pain has lingered.

Putting It All Together

Pain without injury does not mean you are broken.

It usually means the body needs help managing stress and load. With the right approach, most people see steady improvement.