Pain is not only a common part of training and physical activity but it’s a common part of life. The high likelihood is that if you are quite active, you train hard or regularly, or even if you are of a certain age, pain is likely a frequent occurrence. Therefore, waiting for pain to subside is neither intuitive or productive.
Having a basic knowledge of pain is important, because not all pain means the same thing. Some pain is a normal response to loading the body, while other pain is a signal to modify, pause, or rethink how you’re training. Understanding where your pain may be coming from can help you make better decisions about whether it’s wise or acceptable to keep exercising, and how to do so safely.
Pain doesn’t automatically mean you should stop training
Pain is produced by the nervous system to protect you. While it often reflects tissue stress, it’s also influenced by fatigue, stress, recovery, past injuries, and how sensitive your nervous system is on the day.
That’s why pain:
- Doesn’t always mean injury
- Doesn’t always reflect damage severity
- Can fluctuate independently of tissue healing
The key question for training isn’t “Do I have pain?”, it’s “What type of pain is this, and how should I respond to it?”
1. Somatic pain: pain from muscles, joints, and tissues
This is the most common pain experienced during training.
Common training-related examples:
- Muscle soreness or strain
- Tendon pain during loading
- Joint pain with squats, running, or lifting
- Post-exercise stiffness
What it often feels like:
- Achy, sore, sharp, or localised
- Predictable with certain movements or loads
- Settles with rest or modification
Is it acceptable to train with somatic pain?
Often yes, with boundaries.
Somatic pain commonly reflects how tissues are responding to load. In many cases, continuing to train with modified intensity, volume, or range is not only acceptable but beneficial.
Generally acceptable if:
- Pain stays mild to moderate (e.g. ≤3–4/10)
- Symptoms settle within 24–48 hours
- Movement quality remains good
- Pain does not progressively worsen week to week
Caution if:
- Pain is sharp and worsening
- Swelling or loss of function increases
- Pain persists or escalates after each session
2. Neuropathic pain: pain related to nerve irritation
This type of pain requires more caution during training.
Common training-related examples:
- Sciatic pain during deadlifts
- Arm pain or tingling during overhead work
- Numbness or burning during cycling or gripping
What it often feels like:
- Burning, electric, shooting
- Pins and needles or numbness
- Pain travels along a limb
Is it acceptable to train with neuropathic pain?
Sometimes, but carefully.
Nerves are less tolerant of compression and stretch than muscles or tendons. Continuing to train through nerve pain can sometimes worsen symptoms if loads or positions are not adjusted. Additionally, neural pain types don’t always trigger symptoms immediately, so there is no clear incentive to stop. This latency of pain makes it worth exercising much more caution.
Training may be acceptable if:
- Symptoms are mild and not progressive
- No increasing numbness or weakness
- Pain does not spread further down the limb
- Load and positions are modified
Avoid pushing through if:
- Numbness or weakness increases
- Pain becomes constant or severe
- Symptoms worsen during or after sessions
3. Nociplastic pain: pain from a sensitised system
Where it comes from:
Altered pain processing in the nervous system without clear tissue damage or nerve injury. This is a pain type that is often misunderstood but exercise is critical to re-expose the nervous system to safe, normal movement experiences, which helps dial down sensitivity over time.
Common examples:
- Persistent low back or neck pain
- Fibromyalgia
- Chronic widespread pain
- Long-standing tendon pain that hasn’t settled as expected
What it often feels like:
- Pain that seems disproportionate to activity
- Diffuse or poorly localised
- Sensitive to stress, fatigue, poor sleep, or emotional load
- Symptoms fluctuate day to day, despite similar training
Common training-related examples:
- Long-standing back or neck pain with normal scans
- Pain that flares unpredictably with exercise
- Widespread soreness not linked to specific movements
Helpful thing to know:
This pain is real, but it doesn’t mean your body is broken. The nervous system has become overprotective. Rehab focuses on gradually rebuilding confidence with movement, improving capacity, and calming the pain system rather than “fixing” damaged tissue.
Is it acceptable to train with nociplastic pain?
Yes, and often necessary, but not aggressively.
With nociplastic pain, avoiding exercise entirely often worsens sensitivity over time. The goal is graded exposure, not pushing through high pain.
Training is usually encouraged when:
- Pain is monitored and kept tolerable
- Progression is slow and predictable
- Flare-ups are expected but short-lived
- Focus is on consistency over intensity
Less helpful approaches include:
- “No pain, no gain” mindsets
- Large jumps in volume or intensity
- Constantly testing limits
4. Inflammatory pain: pain driven by inflammation
Often this type of pain is easily explained, either by acute trauma (e.g. a twisted knee) or perhaps a disease process (e.g. rheumatoid arthritis). Inflammatory pain responds differently to training load.
Common training-related examples:
- Joint pain and stiffness after rest
- Flare-ups during high-volume phases
- Swelling or warmth in joints
What it often feels like:
- Deep ache and stiffness
- Worse in the morning or after inactivity
- Improves with gentle movement
Is it acceptable to train with inflammatory pain?
Yes, but intensity matters.
Complete rest can increase stiffness and pain, but excessive loading can worsen inflammation.
Training is usually appropriate when:
- Movement is low-impact and controlled
- Volume and intensity are reduced during flares
- Recovery is prioritised
Caution if:
- Swelling and pain escalate after sessions
- Fatigue and pain accumulate across days
5. Referred pain: pain felt away from its source
Referred pain can complicate training decisions.
Examples:
- Shoulder pain driven by the neck
- Knee pain originating from the hip
- Buttock pain linked to the lower back
Is it acceptable to train with referred pain?
Often yes, once the source is understood.
Training the painful area alone may not resolve symptoms, but full training cessation is rarely necessary.
Key training takeaways
- Pain does not automatically mean stop
- Different pain types respond differently to load
- Most people can continue exercising with smart modifications
- The goal is long-term training consistency, not short-term pain elimination
Understanding your pain helps you train with your body rather than against it.
Understanding Pain: What It Is and Why We Experience It
Pain is one of the most common reasons people seek physiotherapy, yet it’s also one of the most misunderstood experiences in the human body. While pain can feel alarming or even overwhelming, it’s important to understand that pain itself is not the enemy. In fact, pain plays a vital role in keeping us safe.
What Is Pain?
Pain is the body’s protective alarm system. It is produced by the nervous system to alert us that something may be wrong or that tissues are under threat. When we sprain an ankle, strain a muscle, or touch something hot, pain encourages us to react quickly, change our behaviour, and allow healing to occur.
However, pain is not a direct measure of tissue damage. Instead, it is an output of the brain based on information it receives from the body, past experiences, beliefs, emotions, and context. This is why two people can experience very different levels of pain from similar injuries, and why pain can sometimes persist even after tissues have healed.
Why Do We Experience Pain?
Pain occurs when sensory receptors (called nociceptors) detect potential danger such as pressure, temperature, or chemical changes. These signals travel through nerves to the spinal cord and brain, where they are processed and interpreted. If the brain decides the situation is threatening, pain is produced as a warning.
This system is incredibly effective, but it is not perfect. In some cases, the nervous system can become overprotective, leading to pain that is stronger, longer-lasting, or more sensitive than expected. Understanding the type of pain you are experiencing can help guide appropriate treatment and recovery.
Somatic Pain: Pain from Tissues
Somatic pain comes from structures such as muscles, joints, ligaments, bones, and skin. It is the most common type of pain seen in physiotherapy.
This type of pain is usually well localised and described as aching, throbbing, sharp, or sore. For example, a hamstring strain, ankle sprain, or sore shoulder after lifting are all examples of somatic pain. It often changes with movement or load and can usually be reproduced with specific physical tests.
Somatic pain typically responds well to physiotherapy interventions such as exercise, manual therapy, education, and gradual loading to restore strength and movement confidence.
Neuritic Pain: Pain from Nerves
Neuritic pain (sometimes called neuropathic pain) originates from irritation, compression, or injury to a nerve itself. Rather than coming from muscle or joint tissue, the source is the nervous system.
This type of pain is often described as burning, tingling, electric, sharp, or shooting. It may travel along a nerve pathway, such as pain running from the lower back down the leg (often associated with sciatica) or from the neck into the arm. Numbness, pins and needles, or altered sensation are also common features.
Neuritic pain behaves differently to somatic pain and often requires a more tailored approach. Treatment may focus on reducing nerve sensitivity, improving movement around the nerve, addressing contributing factors, and gradually retraining the nervous system.
Why This Matters
Understanding what type of pain you’re experiencing helps guide the right treatment approach and reduces unnecessary fear. Pain does not always mean damage, and persistent pain does not mean your body is broken.
At physiotherapy, our role is to help you understand your pain, identify contributing factors, and support your recovery with evidence-based care. With the right guidance, movement and confidence can be safely restored—even when pain has been present for some time.
If you’re unsure about your pain or how to manage it, a physiotherapist can help you make sense of what your body is telling you and guide you toward recovery.
Can we add a section: “Can I train through pain?” and outline any circumstances where this is acceptable
Absolutely — that’s a great and very practical addition for a physio audience. Below is a new section you can insert near the end of the blog. It’s written to be reassuring, evidence-informed, and clearly caveated.
Can I Train Through Pain?
This is one of the most common questions we hear in physiotherapy, and the answer is: sometimes, but it depends on the type of pain and the context.
In many cases, especially with musculoskeletal (somatic) pain, some discomfort during or after exercise can be both safe and helpful. Gentle exposure to movement and loading can improve tissue tolerance, reduce fear, and support recovery. This is particularly true for long-standing or persistent pain, where avoiding all discomfort can actually slow progress. Additionally, many tendon rehabilitation protocols train in to pain and use a pain rating to help determine appropriate lifting loads.
There are, however, important guidelines to follow.
Training through pain may be acceptable when:
- The pain is mild to moderate and feels familiar (e.g. an ache or tightness rather than sharp or severe pain)
- Symptoms settle shortly after exercise or return to baseline within 24 hours
- Pain does not progressively worsen during the session
- Movement feels controlled and confident, not unstable or unsafe
- There are no red flags such as swelling, sudden loss of strength, or night pain
In these situations, a physiotherapist may encourage working within a “tolerable pain range” while gradually building strength, capacity, and confidence.
Training through pain is usually not appropriate when:
- Pain is sharp, severe, or catching
- Symptoms are clearly neuritic, such as increasing numbness, tingling, burning, or shooting pain
- Pain continues to worsen after exercise or lingers well beyond 24 hours
- There is progressive weakness, loss of coordination, or altered bladder or bowel function
- Pain is associated with significant trauma, swelling, or suspected serious injury
In these cases, pushing through pain may increase sensitivity or delay recovery and should be assessed by a healthcare professional.
The Take-Home Message
Pain during exercise does not automatically mean harm, but it should never be ignored or blindly pushed through. The goal is not to eliminate all sensation, but to find the right balance between protection and progression.
A physiotherapist can help you determine what level of pain (if any) is safe, how to modify training appropriately, and how to progress with confidence. With the right guidance, movement can remain a powerful and safe tool for recovery — even when pain is part of the journey.