There’s a condition, called CIPA, where suffers have a congenital insensitivity to pain. This incredibly rare inherited disorder of the nervous system may sound like a fairly appealing condition to have, but because sufferers don’t experience pain, they invariable end up sustaining severe injuries.

Take picking up a hot pan for instance. The immediate pain that’s provoked, results in you instantly dropping the pan. Whilst you may have still sustained a small burn, the severity of the burn would undoubtedly be significantly less than it would have been if you hadn’t experienced pain. The first warning sign people with CIPA would have experienced in that scenario would be the smell of their skin burning..

And the important point I’m trying to illustrate here is this: Pain is not simply a sign that injury has occurred, but also an important sign that injury is about to, or that persistence with a painful activity will lead to an even more severe injury. This concept is particularly relevant to some back and neck pain sufferers. Robin McKenzie, a World renowned New Zealand physiotherapist born in 1931, categorised all back and neck pain into three syndromes: Postural Syndrome, Dysfunction Syndrome, and  Derangement Syndrome. Now, although many may challenge the simplicity of this categorisation, if people understood these first two syndromes, and how one leads to the other, a great deal of back pain could be avoided, as people could self-monitor and self-treat.

So, what is postural syndrome? Well, if I bend my finger backwards, initially it doesn’t hurt, but if I held it in this position for several minutes it would definitely start to. Let it go, and the pain goes, and no damage has been done. That is postural syndrome in a nutshell. If you sit, stand or lie in an awkward position for a prolonged period of time, you will eventually experience pain. Providing you address this, your pain will go, and you will not have sustained an injury that requires treatment.

However, returning to the bent finger analogy. If I was to repeatedly bend my finger backwards and hold it in this position for prolonged periods of time, day after day, week after week, the tissues on one side of my finger would become stretched and lengthened, whilst those on the other would become shortened and tight. Therefore, when I eventually let go of my finger, rather than it returning to it’s normal position, it would stop some way short of normal. And if I tried to move it beyond this new position, I would experience pain. And this is what’s called Dysfunction Syndrome.

We all have postural habits. Take me for instance. When sitting, I invariably cross my left leg over my right, and on the occasions when I try to switch I rarely switch for long, because it is significantly less comfortable. I’ve sat this way so frequently that structural changes have occurred. Similarly, whether sitting in an office chair, the car, or armchair, I will invariably lean to the left. The tissues along the left hand side of my spine will, as a result, have lengthened, and those on the right will have shortened.

Now, the question is, does this matter? Well yes, in that this is progressive; all the time you give in, and constantly assume the more comfortable position, you are reducing your pain free range. And, importantly, if you were suddenly forced to move into your painful tight range, you would be far more likely to sustain injury; with the tight tissues tearing due to inflexibility. So with me, for example, with my right side being my shortened, comparatively less flexible side, if I were playing sports and suddenly had to catch a ball high up to the right, I’d be significantly more vulnerable to injury than I would have been if I was equally mobile on both sides.

So, the message here is symmetry. Try not to favour one side, or one particular position. Watch for asymmetry and try to prevent such habits developing; ideally from a young age, whilst it’s still at the postural syndrome stage, before it develops into dysfunction syndrome. I guarantee if your child carries their rucksack over one rather than both shoulders, it’s always the same shoulder.. And I guarantee if you stand for a prolonged period of time you invariably relax one leg, bending the knee, dropping the hip, and it’s usually the same leg. Address these habits early enough and you will avoid dysfunction developing.

However, if dysfunction has already occurred, it is still highly treatable. With the correct program of stretches, strengthening exercises, and advise, symmetry can usually be restored, and your vulnerability to injury reduced. Obviously, if you live in London, the team at Physiotherapy London would be very happy to advise. But if not, to find a Chartered Physiotherapist near you who is trained in identifying and correcting such asymmetries visitwww.physiofirst.org.uk where you will find a directory of all the Chartered Physiotherapists in private practice in the UK today, and can search according to location. If you have any queries though, do just drop us an email, and we’ll try to point you in the right direction: enquiries@physiotherapy-specialists.co.uk