The Worst Advice I've Heard Given to Patients With Chronic Pain

The Worst Advice I've Heard Given to Patients With Chronic Pain

After years in this field, I've heard a lot of things said to patients that I wish I could walk back for them. Not because the providers were bad people, but because the advice carried real consequences. It kept people scared. It kept them passive. It kept them stuck.

Here's the list. If you've heard any of these, I want to give you a different frame.

'Just Rest It'

Rest is occasionally appropriate in the very early stages of an acute injury. But for the overwhelming majority of chronic pain presentations, rest is one of the least useful things a person can do. Tissue that doesn't get loaded doesn't get stronger. A body that stops moving becomes less capable of tolerating the demands of an active life.

The research on this is clear. Movement, done intelligently and progressively, is almost always better than rest for musculoskeletal pain. The question isn't whether to move. It's how to move in a way that promotes healing rather than aggravating it.

'At Your Age, This Is Normal'

Age-related changes in joints and tissue are real. What isn't real is the implication that those changes mean pain and limitation are inevitable. I work with people in their 60s and 70s who are stronger, more mobile, and more confident in their bodies than they were a decade ago. Renee, one of my patients, is 70 years old and more physically capable than she's been in years.

Aging is not a sentence. It's a context. And within that context, there is enormous room for improvement with the right approach.

'Your Imaging Shows Significant Degeneration'

Radiological findings and pain levels correlate much less than most patients are led to believe. Study after study has shown that the majority of adults over 40 have disc changes, arthritic changes, and other findings on imaging that produce zero symptoms. Leading with imaging to explain pain plants a story in the patient's mind that often does more harm than the physical finding ever would.

Imaging has a place. But it should inform a clinical picture, not define a person's expectations about their body.

'Avoid Any Exercise That Causes Discomfort'

This one is particularly damaging because it sounds careful. But all tissue adaptation involves some level of discomfort. Strength training, by definition, challenges tissue beyond its current capacity. If we eliminate all exercise-related discomfort, we eliminate the mechanism of improvement.

There's a meaningful difference between pain that signals tissue damage and discomfort that signals tissue being challenged. Teaching patients to recognize that difference is one of the most important things a provider can do. Telling them to avoid all discomfort does the opposite.

'You'll Probably Need Surgery Eventually'

For a small subset of patients with specific presentations, this is true. For the majority of people who've been told this, it isn't. Surgery is frequently presented as an inevitability when conservative care hasn't worked, rather than asking whether the right conservative care has actually been tried. A comprehensive, strength-based, progressive approach resolves the majority of musculoskeletal pain presentations without any surgical intervention.

If you've been told surgery is in your future, it's worth getting a second opinion from someone who will first tell you what a fully committed non-surgical approach actually looks like.

Ready to stop managing pain and start rebuilding?

If you're an active adult in the Overland Park area looking for a clear, structured plan that goes beyond quick fixes, I'd love to connect.

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