Why Chronic Pain Often Has More to Do With Load Than Damage
By Dr. Andrew Kakishita, DC
Why Pain Becomes Chronic
Chronic pain rarely starts as chronic.
Most long lasting pain begins with a period of overload. The body is asked to handle more stress than it can recover from. Over time, tissues and nerves become more sensitive.
This is why pain often builds slowly rather than starting with one clear injury.
What Load Really Means
Load is not just exercise.
It includes work demands, standing, walking, sitting, stress, sleep, and life responsibilities. All of these add stress to the body.
When total load stays high for long periods, recovery becomes harder. Pain can linger even if no new damage is happening.
Why Damage Is Not Always the Problem
Many people assume pain means something is torn or broken.
In chronic pain, tissues are often healed or healing. The issue is that tolerance has dropped. The system reacts strongly to normal stress.
This does not mean the pain is imagined. It means the body needs help rebuilding capacity.
How Load Is Addressed in Care
Care focuses on balancing load and recovery.
This includes adjusting daily activity, restoring movement, and gradually rebuilding strength and tolerance. Rehab is often done in a way that feels manageable rather than exhausting.
For some people, tools like shockwave therapy are useful. Research shows shockwave therapy can help improve tissue response and load tolerance in chronic conditions when combined with movement based care.
Why Doing More Is Not Always Better
Adding more exercises without adjusting daily load can backfire.
This is why rehab sometimes feels like it makes pain worse. The total stress has not changed. Effective care often requires doing less in one area to make progress in another.
The Takeaway
Chronic pain is not a sign that your body is broken.
It often reflects an overload problem. With the right balance of movement, recovery, and support, most people improve over time.