Anyone who has ever had sciatica knows just how painful it can be. Sciatica is one of the most painful symptoms where musculoskeletal conditions are concerned but sadly many other conditions can cause considerable pain. I have found that, once patients understand the nature of the pain they are experiencing, the better placed they are at finding a road to recovery. The good, the bad and the ugly is my simplified way of describing different types of pain to my patients.

Good pain is the term I use for the pain you feel when you are working or stretching the muscles and tendons. This is sometimes felt during the activity, whether it be your occupation or your hobby, and sometimes you feel it the morning after. Anyone who has a hard physical occupation or trains regularly for their hobby, such as sport or dance, will know this type of pain only too well.

Good pain can also be due to the treatment you may require to aid your recovery from an injury or illness. For instance, manual therapy or exercise therapy may cause some discomfort. In this scenario with this type of pain we can ‘knock at the door, but don’t push it open’.

Bad pain is the term I use for the pain felt due to an injury. It can be caused by either an impact such as falling or running into something, or something impacting on you. It could also be caused by over-extending or stressing a muscle, tendon or ligament such as with a strain or sprain. Bad pain can also be caused by a repetitive strain injury (RSI), i.e. over-use of a muscle or tendon, which could be either occupational or down to the activity you enjoy, which can be anything from gardening to gymnastics.

Ugly pain is the term I use for pain caused by disease, such as from osteoarthritis, rheumatoid arthritis or disease of the internal organs, i.e. heart, liver, lungs, etc. which can be due to life-style or genetics.

The point is this, to help us recover from the Bad pain and to assist in the reduction of the effects of Ugly pain, we have to accept the Good pain. Once we accept this and are more in tune with the cause of our pain and the action needed to help us recover will we find that our pain starts to reduce.