Why You Have Good Days and Bad Days

Anyone who has been dealing with joint pain for a while knows that the pain they feel is not consistent. Some days can be downright unbearable and then other days pretty good. My patients often wrack their brains trying to figure out what they did to cause a bad day. They blame some activity they did that day, or perhaps a supplement or medication they forgot to take, or of course, it might have been the weather. We inherently strive to understand these inconsistent symptoms with linear explanations of cause and effect.  While linear explanations are quite satisfying, when it comes to understanding something as complicated as pain, they are often incorrect and can lead to frustration. To better understand why you hurt more on some days than others we have to really understand what pain is and how we perceive it.

What is Pain and How Does it Work?

The International Association for the Study of Pain defines pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. While we often think of pain as being a direct result of an injury or tissue damage there are actually a wide variety of factors that will modulate the intensity of pain we feel. We now know that all pain is 100% produced by the brain. When you get hurt special damage sensing nerve cells send signals up to the brain. Your brain then processes this information and determines how much pain to feel and how you should react.

When perceiving pain, your brain takes many more factors into account than just the physical sensation that you endured. As a result, the same physical stimulus can elicit different reactions based on these other factors. For example, if I am out camping and I feel a slight tickle on the back of my neck from the tag on my shirt, I may flail and panic because in the background my brain is protecting me from spiders, ticks, and all the other creepy crawlies that are out to get me in the woods. If I feel that same tickle on my neck in my living room, I may just give a casual scratch or not even notice it at all. As a protective mechanism, my nervous system is overly sensitive to light skin contact when I’m camping versus sitting at home, so the same stimulus yields a very different response. The same process happens when dealing with chronic joint pain. Your nervous system can get sensitized for a host of reasons including physical stress, emotional stress, immunological responses, the amount and quality of your sleep, nutrition and hydration, and yes, perhaps even the weather, especially if you believe it to be. So when some activity hurts one day and not the next, understand that it is much more than just physical activity that contributes to pain intensity.

How to Handle Bad Days

So you’re having a bad day, everything hurts. What should you do about it? Try to approach pain with curiosity instead of frustration or anger. First, think about if there is an obvious reason that you are more sensitive today. The key here is an obvious reason. Perhaps you did something far more physically demanding than you normally do and some soreness would be expected. In that case, you want to rest, avoid further irritation, perhaps apply some ice and expect to feel better the next day.

If no obvious reason comes to mind, then try to accept that your nervous system is a little extra sensitive today for reasons you may not be able to explain. The key is not to panic and not to blame yourself. Do the things you know are healthy for you like eating well, staying hydrated, getting a good night’s sleep, and moving or exercising within your comfortable tolerance. Flare-ups and bad days are inevitable, take solace in the knowledge that they will pass. Be kind to yourself and allow tomorrow to be a better day.