When people try to get on top of stubborn musculoskeletal pain, they often get tripped up by a few big misunderstandings. And those misunderstandings—completely innocent as they are—tend to hold them back from real, lasting improvement.
One of the biggest mix-ups is assuming that where you feel pain must be where the problem is. We know this isn’t always true; for example, one of the early signs of a heart attack can be pain in the left shoulder, not the chest. With musculoskeletal pain, the same kind of mismatch can happen.
So what do most people do? They laser-focus on the sore spot. They rest it, stretch it, poke it, strengthen it—or they pull back from sport, exercise, or work to “protect” the area. But if the true cause is actually elsewhere, all that effort becomes a kind of well-intentioned detour. It wastes time, money, and emotional energy, and it can leave people feeling frustrated and stuck.
At NWPG, we see this every day. Around 80% of the time, the source of a patient’s symptoms is not in the place that hurts. Research on Regional Interdependence backs this up too: the body is interconnected, and pain often shows up downstream from the actual issue.
Another common belief is that pain and tissue damage always arrive together, hand-in-hand. But modern research paints a different picture. Especially with accumulated strain—tiny stresses stacking up over days, months, or even years—there’s usually a big buffer between when tissue starts feeling pressured and when real damage begins. The brain often sends a warning signal (that familiar “ouch”) long before anything is actually injured. In other words, pain often gives you time to act.
We also see a lot of confusion around scans. It’s easy to assume that anything that shows up on an X-ray, ultrasound, or MRI must be the culprit. But studies consistently show poor correlation between imaging and pain. Plenty of people have “abnormalities” on scans and feel perfectly fine. Others have significant pain with squeaky-clean imaging. What you see on a scan doesn’t reliably match what someone feels.
This all circles back to the role of the brain. It’s constantly sorting and interpreting signals from the body, trying to keep you safe. When your system is overloaded, the brain’s warning message is pain—its way of nudging you to change course before genuine damage happens. But if those warnings go unheeded, that’s when injuries like muscle tears, tendon issues, and postural strain can show up.
Seen this way, the brain is less of a troublemaker and more of a guardian—one with a remarkably early detection system. And when you start understanding pain through that lens, it becomes much easier to make meaningful, long-term shifts in both comfort and function.
References
Brinjikji W et al; Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27.
Girish G et al; Ultrasound of the shoulder: asymptomatic findings in men. AJR Am J Roentgenol. 2011 Oct;197(4):W713-9. doi: 10.2214/AJR.11.6971