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Understanding Pain: A Holistic Approach for Rehabilitation and Chronic Illness Management

Updated: Jul 10, 2023

Pain is a complex and multifaceted experience that can significantly impact an individual's quality of life. Understanding pain, especially in the context of rehabilitation and chronic illness management, is crucial. This article delves into the various dimensions of pain and highlights the importance of a holistic approach in pain management.

What is Pain?

Pain can be defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. There are two main types of pain: acute and chronic. Acute pain, like a paper cut, serves as information, alerting the body to potential harm. Chronic pain, on the other hand, persists beyond the normal healing time and can be distressing, affecting sleep, mood, and movement.

The Biopsychosocial Model

The Biopsychosocial Model is essential in understanding pain. It posits that biological, psychological, and social factors all play a significant role in human functioning in the context of disease or illness. This model is particularly relevant in understanding the multifaceted nature of pain.

Biological Aspect of Pain

The biological aspect of pain involves the physiological processes. The nervous system plays a central role in the perception of pain. Sometimes, pain signals become centralized, meaning that the nervous system remains in a state of high reactivity, causing pain even in the absence of an injury.

Psychological Aspect of Pain

Pain is not just a physical sensation; our emotions, thoughts, and mental health can significantly affect how we experience pain. Stress, for example, can exacerbate pain. Past experiences with pain can also influence pain tolerance. For instance, men trying TENS machines to simulate period pain have shown to have lower pain tolerance compared to women who are accustomed to the pain.

Social Aspect of Pain

Our social environment and interactions can also impact pain. Cultural influences can shape how we perceive and express pain. Additionally, individuals who are isolated may experience heightened pain perception compared to those with social support. Pain can sometimes cause individuals to withdraw from social interactions.

Pain and Personal Trainers

Personal trainers often encounter clients experiencing pain. It is vital for trainers to understand the difference between muscle pain and other types of pain. Common mistakes include asking clients to describe the pain but not knowing how to interpret or act on the information. Personal trainers can play a significant role in pain management by integrating the biopsychosocial understanding of pain into exercise programming.

Chronic Illness and Pain

Chronic illness can exacerbate pain perception. For individuals with chronic illnesses, pain can become a regular part of life, and managing this pain is crucial for improving their quality of life.

Pain Science Research

Recent research in pain science is continually shaping our understanding of pain. For example, studies have shown that genetic factors can influence pain perception. One interesting finding is that people with red hair, due to the MC1R gene, have different pain perceptions and may require different doses of anesthesia (Liem, E. B., Joiner, T. V., Tsueda, K., & Sessler, D. I., 2005).

Practical Strategies for Personal Trainers

Personal trainers should tailor exercise programs for individuals with chronic pain. There has been a shift from the RICE (Rest, Ice, Compression, Elevation) protocol to PEACE (Protect, Elevate, Avoid anti-inflammatory drugs, Compress, Educate) and LOVE (Load, Optimism, Vascularization, Exercise) in pain management.

Communication and Empathy

Effective communication and empathy are crucial in working with clients experiencing pain. It is important to build trust and understanding. Using the language that clients use to describe their pain can be empowering for them.


Understanding pain requires a holistic approach that considers the biological, psychological, and social dimensions. For rehabilitation and chronic illness management, it is essential to recognize that pain is not just a physical sensation but is influenced by emotions, thoughts, social environment, and even genetics. Personal trainers and healthcare professionals must be equipped with the knowledge and empathy to effectively support individuals in managing pain. Tailored exercise programs, effective communication, and an understanding of the latest pain science research are key components in this process.

If you're experiencing back pain, read my other article on how to get rid of it for good. Additionally, I have another one that tackles shoulder pain. And if you have any questions or need more help and information, just reach out!


  1. Liem, E. B., Joiner, T. V., Tsueda, K., & Sessler, D. I. (2005). Increased sensitivity to thermal pain and reduced subcutaneous lidocaine efficacy in redheads. Anesthesiology: The Journal of the American Society of Anesthesiologists, 102(3), 509-514.

  2. Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological bulletin, 133(4), 581.

  3. Louw, A., Diener, I., Butler, D. S., & Puentedura, E. J. (2011). The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Archives of physical medicine and rehabilitation, 92(12), 2041-2056.

  4. Nijs, J., Kosek, E., Van Oosterwijck, J., & Meeus, M. (2012). Dysfunctional endogenous analgesia during exercise in patients with chronic pain: to exercise or not to exercise?. Pain physician, 15(3S), ES205-ES213.

By understanding pain from a holistic perspective, we can better support those in rehabilitation and manage chronic illnesses effectively. This approach empowers individuals to take control of their pain and improve their quality of life.

This is just some of the things we delve into in "understanding your client with chronic illness and injury" course.

Extra references discussed at the Aus Active Health Summit:

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