If you have been told your pain is just part of getting older, that is not the whole story. Modern pain science shows that pain is produced by the brain in response to what the nervous system perceives as danger, rather than directly by tissue damage. In a large review of spinal imaging in people without back pain, disc degeneration was found in an estimated 96% of people aged 80 (Brinjikji et al, 2015). Age on its own is rarely the whole explanation, which means there is often more worth exploring than you have been told.
If you’re in your 60s, 70s, or 80s and you’ve been living with pain for a while, chances are someone has told you a version of the same thing.
“It’s just wear and tear.”
“You can’t expect to feel young forever.”
“It’s just what happens as you get older.”
Our principal physiotherapist Rick Chiang hears this from patients constantly. And he understands why people believe it. It’s what most of us have been told our whole lives.
But modern pain science tells a different story. And it changes what is worth exploring about the pain.
What pain actually is
Pain is not made where you feel it. It is made in your brain.
Throughout your muscles and joints, there are tiny sensors. Think of them as danger detectors. When something in the tissue isn’t right, whether that’s pressure, strain, temperature or inflammation, those sensors send a danger signal up through your nerves, into your spinal cord, and up to your brain.
Your brain weighs up that signal alongside everything else it knows about your situation, and it decides whether to produce pain.
The pain itself isn’t made in your knee or your back. It’s produced by your brain. Pain is your body’s alarm system, rather than a direct readout of tissue damage.
This is why two people with the same injury can feel completely different things. One might be in agony. The other might barely notice. The brains are producing different outputs from similar signals, based on all the other information they’re taking in.
Your pain alarm has a volume dial
When pain hangs around for a long time, your nervous system can turn the volume of that alarm up. It can start producing pain more easily, in response to smaller and smaller signals. Sometimes it produces pain even when there’s no new tissue problem to respond to.
You are not imagining the pain. It is a physical change in how your nervous system is functioning. Pain scientists call this central sensitisation, and it’s well established in the research.
There is good news in that. Because this is a change your nervous system has made, it’s often also a change your nervous system can unmake due to neuroplasticity. The nervous system stays adaptable throughout life.
So what might be causing the pain?
If the wear and tear is not the driver, what is?
Rick’s answer, and the thinking behind his approach called Original Point Therapy, is that pain in older adults is often driven by patterns the body has developed over decades: compensations for old injuries, habitual postures, muscles that have become chronically short or weak, and a nervous system that has become sensitised over years of holding onto pain.
It is not “just ageing.” Often it is potentially changeable.
Every person is different, pain can have several contributing factors at once, and a single cause cannot always be identified. But the question worth asking isn’t “what wear and tear does my scan show?” It’s “what might be setting my alarm off, and can we settle it?”
Why this matters for you
If you’ve been told nothing can be done for your pain because it’s just age, or just arthritis, or just wear and tear, that often simply isn’t true.
Sometimes the real cause of a person’s pain involves factors outside the painful area. We have seen people who lived with pain for ten, twenty, or thirty years and saw meaningful change once factors that had not previously been addressed were identified. That is not everyone’s experience, and no assessment can promise it in advance. Sometimes the answer is muscle work. Sometimes it’s addressing a compensation pattern that started decades ago. Sometimes it’s helping the nervous system settle. Usually it’s a combination.
Our mission is to help people pain free naturally without medication, injection and surgery. That mission applies at every age. Age itself is not a reason to stop looking for what might be causing your pain.
Start with a concierge appointment
If you’ve been living with pain and you’ve been told to just live with it, the way to start is a concierge appointment. It’s a short, no-pressure call with Kayla, our patient concierge (trained as a nurse). She’ll listen to what’s going on, ask what you’ve already tried, and help you work out whether a full assessment with Rick or one of our other physiotherapists is worth booking.
Rick also runs free community workshops across Brisbane on this exact topic: what might be driving chronic pain and what can be explored about it. If you’d like to attend one before making any commitment, mention it on the call.
Book here: https://painfreephysio.com/booking/
Two Brisbane clinics: Sunnybank Hills and Robertson.
FAQ
Not usually, no. Ageing does change the body, and those changes often show on scans. But pain is produced by the nervous system rather than by the scan findings themselves, which is why many people with significant wear and tear feel nothing at all. Age on its own is rarely the whole explanation.
Because these changes are common at every age. In a large review of spinal imaging in people without back pain, they were found in over a third of pain-free 20-year-olds and in an estimated 96% of people aged 80 (Brinjikji et al, 2015). The scan describes what your spine looks like. It cannot on its own tell you what is hurting.
Often it can. How long you have had pain matters less than whether anyone has looked beyond the painful area. Even when pain has been present for many years, a thorough head-to-toe reassessment may identify factors that could be contributing to it.
It is the term pain scientists use for a nervous system that has become better at producing pain. After a long period of pain, the system can start responding to smaller signals, sometimes with no new tissue problem behind them. It is a physical change, and because the nervous system stays adaptable, it is one that can often settle.
A comprehensive head-to-toe assessment may identify factors that could be addressed or managed differently. Every person is different and pain often has more than one contributing factor, so nobody can tell you in advance what will be found. What it does do is look beyond the area that hurts.
No. You can book directly. A referral is only needed for certain funding arrangements, and our team can talk you through whether any of those apply to you.
