Therapy thoughts (1/5/25) Is what causes pain the same as what maintains pain?

The topic for today is a complex one, What causes pain may not be what maintains it!

Patients and clinicans what to know "What is causing this pain", often that means a specific tissue. Firstly this is a source of pain, rather than a cause of pain, identifying a tissue does not = why it may hurt.

But secondly, does causation change over time? This is why we need to better understand different elements of causation such as...

• Risk factors
• Inciting events such as physical ones 
• Maintaining factors

So maintaining factors may not initiate a problem, such as a physical event, but they maybe responsible for it going on for longer than it might with someone else.

We could also look at prognostic models here for some guidance. 

This could be adaptations within the nervous system, such as it becoming more responsive and sensitised, after all the most predictive factor of future injury is a previous one.

Could it be changes in psychology  such as fear and the effect on behaviours? 

Could it be motor adaptations such as avoiding specific movements or positions?

Could it be lifestyle changes that change our eco system to a more pro inflammatory one than it was before? 

So treating a "cause" might not be as simple as identifying a tissue, and that cause may change over time with maintaining/prognostic factors not being the same ones as started the problem in the first place!