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  • Writer's pictureBeth Abney

What Causes Pain Without Injury: A Massage Therapist’s Perspective

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You wake up in the morning with an aching back or a crick in your neck. You’re not injured, yet you have this pain. There was no trauma, the pain just came out of nowhere. What’s going on? What causes pain without an injury?

We’ve all experienced this at one time or another. It’s frustrating to not know the source, and hard to remedy if you don’t know what caused it. While it could be any number of things, in this article I’ll explain what it is for the majority of clients I see.

I’m not a doctor, but I’ve been treating people with different types of pain for 17 years. There are many injuries and pathology that cause pain. That’s not what I’ll be talking about. I’m going to talk about what’s causing those annoying aches and pains that pop up seemingly out of nowhere - and what to do about it.

Understanding What Causes Pain Without Injury: The Everyday Factors

What causes pain without injury? Often, these aches arise from lifestyle factors such as poor posture or overuse of muscles. Emotional stress can also play a role, making it complex but often manageable. Here are some everyday factors that can lead to this type of pain:

  • Poor posture

  • Overuse of muscles

  • Emotional stress

  • Lack of physical activity

  • Repetitive strain

  • Ergonomic issues at work or home

  • Sleeping in an awkward position

  • Diet and dehydration

  • Footwear choices

  • Hormonal fluctuations

  • Weather changes

  • Underlying medical conditions (e.g., arthritis, fibromyalgia)

The 2 Most Common Causes Of Pain Without Injury

There are a litany of things that can cause pain, but when you remove trauma and disease from the list, it’s usually one of two things. It’s either the cumulative effect of many small stressors over time, or it’s the result of something habitual. In either case, there’s no pain in the beginning. It takes time to manifest. That’s why flare ups seem so mysterious.

Let’s take a closer look at how this works, and what to do about it.

Common Causes Of Pain

The Cumulative Effect

This is the straw that broke the camel's back. With the cumulative effect, pain is the result of many small stressors over time. These stressors are so small, they seem insignificant. Often, the pain seems to come out of nowhere.

This pain often presents as something caused by what seems like nothing. For instance, you bend over to tie your shoe, and your back goes out. You tie your shoes everyday, with no problem! What the heck happened?

How It Happens

Let’s stick with the example of throwing your back out while tying your shoe. The first thing you need to know is this: it wasn’t caused by tying your shoe. You’ve been building up to this moment for a while now.

Throwing your back out typically refers to the muscles in your low back going into spasm. It can feel far more serious than muscle pain because it’s incapacitating and immobilizing. So what’s going on here?

Muscles go into spasm to prevent a certain movement from happening. The muscles are either exhausted and can’t do any more work, or they’re protecting something else from injury. Basically, they go into spasm to keep you from injuring yourself, and it really freaking hurts!

Most likely, you’ve been putting a lot of stress on your lower back over the past few days/weeks/months. It wasn’t just one thing. It was several things in a row. For instance, maybe you spend most of your time sitting in a chair, which has weakened your core. Then, you babysat your grandson last weekend and had to pick him up off the floor a few times. Yesterday, you spent an hour on your hands and knees pulling weeds in the garden. Most likely, there was little to no pain during any of that. Then today, when you go to tie your shoe - your back says “NOPE! NOT DOING IT!”

That’s how the cumulative effect works. At first, the stressors are not a big deal because your muscles recover so quickly you don’t feel it. However, the strain over time makes you less able to recover. You probably won’t notice it until you hit your limit. Once you hit that threshold, you tip the scales and the pain is on.

Preventative Measures

You can avoid the impact of the cumulative effect by being mindful, learning from past experience, and improving the way you use your body.

Be Mindful: You can’t change what you’re not aware of. The first step towards prevention is paying attention to the way you use your body. Often, there are signals telling you “this is gonna hurt later” that are easy to ignore. Feelings of fatigue or weakness usually come before pain. A movement that’s jerky, off balance, or that feels strained is not something that should be repeated.

Learn From Experience: Once you start to recognize triggers, adjust your strategy. If the last time you spent the whole afternoon working in your yard, you hurt your back, don’t do that again. You can still work in the yard. Just do it differently. Do it in shorter time increments, get better tools, or ask for help. If you notice yard work only seems to bother your back after long car rides, don’t couple those activities together anymore.

Improve The Way You Use Your Body: Sometimes the activity isn’t the problem. It’s the way you do it. If you can’t straighten up after being in a chair for hours, don’t sit so long. If your back hurts when you bend over, engage your core before you bend. If you’re straining to pick up your grandson, sit down and let him crawl in your lap instead. Improper movement causes unnecessary strain on your body. If you fix that, there’s no cumulative effect.

The Habitual Offender

When you do the same thing over and over, there’s going to be an impact on your body. Recurring pain that comes & goes or is always lingering in the background is often the result of a habitual movement, position, or activity. Your pain might go away for a little while after stretching, exercising, or getting a massage. Then, a few days later it returns.

How It Happens

We all have bad habits, and with every bad habit comes a consequence. Poor posture and ergonomics play a big role in the chronic tension we experience everyday. Sometimes that tension turns into pain. It’s a kind of pain you recognize, but can’t quite put our finger on where it's coming from or what’s causing it.

You know that slouching is bad, and so is being stuck at a desk all day. What you may not know is that the pain across the middle of your back is caused by slouching. You slouch so often you don’t even notice doing it, but you notice the pain in your back.

That headache you get by the end of every work day might be from mental stress, but it could also be from the position you’re sitting in. When we stay in one position, especially if it’s not a neutral position, for an extended period of time, it strains our muscles.

It’s often hard to connect the dots because the pain doesn’t usually start the instant you slouch or sit at your desk. It takes time and/or repetition before you start to feel it. Usually, you’re busy with something else by the time you notice the pain.

Much like the cumulative effect, pain caused by habitual movements or postures are the result of strain over time.

Preventative Measures

Work on improving your posture and moving around more. Pay attention to positions you rest in for long periods of time. If you start to see a pattern of that nagging pain popping up during or after being in that position, change it.

Recently, I connected a recurring pain in my neck to the way I prop myself up on pillows to read at night. This searing neck pain plagued me on a regular basis, and it seemed to come in waves. Sometimes I wouldn’t have it for weeks, and other times it would be every day (much like my reading habit).

I started to notice my neck hurting towards the end of my reading sessions. This wasn’t the only time I felt that pain, but it always happened after I’d been laying on the couch for a while. Eventually, I noticed when I didn’t read for several days, that pain didn’t pop up at all. Once I connected the pain to my favorite reading position, I started sitting up straight and held the book in front of my face when I read. Not as cozy as being propped up on pillows, but my neck pain completely went away after that.

The best way to prevent pain from habitual offenders, is to pay attention to when it hurts. Monitor what you’re doing and what affects the pain. Once you find a link, change your habit.

Self-Care Tips For Feeling Better (and staying better)

You may not always be able to identify what’s causing your pain. If you can, make a conscious effort to change your activities, postures, or time spent in a certain position. Here are some general guidelines for self-care, regardless of your issues.

Stretching & Exercise

The more you move around, the less likely you are to develop pain from prolonged positional strain. Taking a walk on your lunch break, doing a few stretches throughout the day, or attending a regular yoga class can help combat the effects of tension building up in your muscles.


You can’t change what you don’t notice. Pay attention to what makes your pain worse or feel better. Pain that’s affected by movement is usually musculoskeletal pain - which is the best kind to have because it’s easily remedied. Be mindful of the way you use your body and the positions you rest in. Changing your posture takes some effort, but it can change everything.

Regular Massage Therapy

Getting regular massage therapy can prevent too much tension from building up in your muscles. If you can get a massage every 2-4 weeks, the majority of pain caused by the cumulative effect and habitual offenders can be avoided. If that’s not in your budget, 6-8 weeks can help diminish the intensity of that kind of pain. However, you still need to do the work of being mindful and moving your body regularly. Massage coupled with those efforts will yield the best results.

When to Consult a Professional

While it is quite common to experience occasional aches and pains without a clear cause, it is important to recognize when it’s time to consult a doctor. If the pain is persistent, intensifying over time, or is accompanied by other symptoms such as nausea, numbness, tingling, or weakness in the limbs, seeking medical advice should be a priority. Moreover, if the discomfort is interfering with your daily activities or preventing you from getting a good night's sleep, it could be a signal that there is a more serious issue at play.

Sometimes the pain could be linked to underlying medical conditions, like fibromyalgia, arthritis, or even signs of heart issues. Early intervention can prevent minor issues from evolving into more serious problems. For instance, what starts as a slight discomfort due to poor posture could escalate into chronic pain over time, if not addressed promptly.

Therefore, while it is beneficial to explore self-care strategies and lifestyle adjustments to manage minor aches and pains, there should be a clear threshold where medical intervention is sought. Keep an open line of communication with your healthcare provider, and don’t hesitate to consult them when pain arises. This can be an essential part of maintaining your overall wellbeing.


Aches and pains are a normal part of life. Muscle pain is often caused by the cumulative effect of many small stressors over time or due to a habitual offender, like poor posture. You can mitigate these problems by being more mindful of the way you use your body and what aggravates the issue. Once you’re able to pinpoint the culprit, change your habits to change your experience. If you can’t put your finger on what’s causing it, make a point to move around more regularly, see a massage therapist, or contact your doctor if it worsens.

Disclaimer: This article is intended for informational purposes only and does not serve as a substitute for professional medical advice or treatment. Individual experiences with pain can vary significantly. If you are experiencing persistent or worsening symptoms, it is always best to consult with a healthcare provider.

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