Why does my injury still hurt even though the scan says it’s healed?

Physios don’t base progress on how wonderful or scary a scan looks. A scan showing a spinal disc herniation can exist without symptoms, the same way a scan showing a healed fracture can still produce pain. Two main reasons are: Pain sensitivity and Reduced physical capacity.

Pain sensitivity

Sometimes, the body can experience central sensitisation, and this can become chronic. This is where the central nervous system becomes overactive and amplifies pain signals. Normal touch and movement sensations can be registered in the brain as pain. This can remain the case despite the injured tissue having healed. Some factors that drive central sensitisation include: repeated or long-standing pain episodes, stress, poor sleep, and fear of movement and further injury.

Reduced Physical Capacity

From the moment a body part gets injured, experiences pain and inflammation, muscular inhibition can start to occur in some areas and muscle guarding can happen in others. If this process remains unaddressed, there can be new or ongoing pain after the original injury has healed. For an injury that requires weeks of immobilisation or relative rest, we cannot expect to go from 0 (resting) to 100 (complete normal life) and feel the same in either situation.

So what should we do?

The main thing that helps eliminate pain after an injury has healed is early intervention. Dealing with pain early, preventing flare-ups, and understanding the injury fully is what will ensure a successful and speedy recovery.