Pains that appear "for no reason"… really?

"I woke up Monday morning with a sore neck, but... I didn't do anything special during the night!?"

"I came back from my run, everything was fine, and a few hours later my ankle was stiff and painful, but I didn't fall?"

Do these situations sound familiar? Perhaps you or a family member has experienced something similar. Pain can occur without an accident or any obvious cause. An evaluation can help you understand what’s contributing to your symptoms.

What is the difference between an injury and pain?

An injury is damage to tissue, while pain is an unpleasant experience that is both physical and emotional. Damage can affect the skin, a muscle, a ligament, or other tissue. Pain may accompany an injury, but it can also exist without detectable damage. Its intensity does not directly reflect the extent of the damage. ¹

A bicycle fall can result in a scrape, a pulled muscle, or a sprain. These injuries can be painful. The inflammation that follows an injury helps repair the tissues but can also increase their sensitivity. However, the pain you feel depends on several factors, not just the injury itself.

A cramp or muscle soreness that occurs without any trauma is often caused by something other than an actual muscle injury, as explained in our article on the real cause of muscle cramps. Pain following an injury may subside over the course of days or weeks, but it does not always follow the pace of tissue healing. Injury and pain are therefore linked in certain situations, though they are not the same thing.

Some recent episodes of back pain improve quickly. In a 1994 study of 103 people whose pain had begun less than 72 hours earlier, 90% reported no further pain or limitations after two weeks. ² This finding applies specifically to this group. Persistent pain warrants an evaluation and a tailored treatment plan. Our comprehensive guide to back pain explains the different scenarios.

You may experience real pain even when no injury is found. The absence of a visible injury does not make your pain any less real.

Le bref mal de tête provoqué par un aliment très froid en est un exemple. Cette douleur peut être forte et disparaître rapidement quand le Contact avec le froid cesse. La classification des maux de tête décrit ce phénomène³.

Cette explication ne s’applique pas à tous les maux de tête. Un mal de tête soudain et extrêmement intense, ou accompagné d’une faiblesse, de confusion ou de difficultés à parler, demande une évaluation urgente. Les signes d’alerte d’un mal de tête doivent être pris au sérieux⁴.

Pain often causes you to protect a certain part of your body, but it does not prove that a tissue is under too much strain. Your health, your emotions, and your life circumstances can influence this experience. ¹ Persistent pain can linger even after an injury has healed. Our guide to chronic pain explains these interactions.

How does an overuse injury occur?

An overuse injury can develop when the stress placed on tissue exceeds its ability to withstand it and recover. It can occur without a fall or a single impact. The duration, intensity, and repetition of activities, as well as recovery periods, all play a role. However, pain after activity does not necessarily confirm an injury: an evaluation distinguishes between a possible injury and other causes of pain.

If pain occurs during or after an activity, consider what has changed recently:

• A longer or more intense workout, with more jumps, twists, or exertion
• A physically demanding, unusual activity, such as spring cleaning, moving, or shoveling snow
• A position held for a long time, such as standing at a concert or sitting on a couch
• A change in office location, workstation, or task assignment
• Fewer breaks or rest periods between activities

In runners, the way forces increase with each step can also be studied. A review of thirteen studies compared individuals with and without a history of stress fractures. This type of fracture is associated with repeated stress. The studies focused on the tibia, one of the two bones in the lower leg, or on the bones of the foot. The rate at which vertical force increased differed between the groups, whereas there was no clear difference in peak force. ⁵ This association does not account for the causes of all running injuries. If injuries keep recurring, see “Why Do I Keep Getting Injured While Running?”

What factors predispose you to an overuse injury?

Inadequate recovery and significant fluctuations in training intensity are among the factors to consider regarding overuse injuries. Sleep may also play a role: a review of seven studies links consistently insufficient or poor-quality sleep to a higher incidence of sports injuries among adolescents. The findings are less clear when it comes to a single poor night’s sleep. ⁶ This association does not prove that better sleep will prevent an injury.

Your healthcare provider may also ask you if certain aspects of your health or habits have changed. This information is used to tailor your care; it does not, on its own, indicate the cause of your pain.

• Illness
• Lack of sleep
• Change in diet
• More time spent sitting with very little movement
• A decline in physical fitness, for example, between summer and winter
• Frequent consumption of alcohol or tobacco

Pain in the front of the knee may occur during a period of intense training. In a study of 1,008 military recruits followed for twelve weeks, 8.75% sought medical attention for this problem. ⁷ The study describes the frequency of this pain during training but does not identify a single cause. Our guide on pain in the front of the knee explains possible treatments.

How to control overuse pain?

Adjusting your activities and gradually resuming exercise can help manage pain caused by overuse. You can temporarily reduce the duration or intensity of tasks that worsen your symptoms, while continuing to perform movements that you can tolerate. Your physical therapist will then tailor the exercises and progression to your specific condition. Any new, severe, or worsening pain should be evaluated.

How do you determine the amount of force applied to the fabric?

You can think of the day’s activities as expenses in a budget. A long run, work, and housework all add up. This analogy helps you organize your activities and breaks. It doesn’t allow you to measure a tissue’s resilience exactly, nor does it mean that pain indicates you’ve gone over budget. In particular, chronic pain can persist even without overexertion.

Pour une douleur autour de la rotule, appelée douleur fémoro-patellaire, les exercices adaptés au genou et parfois à la hanche, accompagnés d’explications, constituent les soins de base recommandés. Un guide clinique de 2024 soutient cette approche⁸. Une douleur à l’avant du genou ne conduit donc pas d’emblée à une chirurgie.

The outcomes of a surgical procedure must be evaluated for each specific condition. A review of six trials, involving 277 participants and certain orthopedic procedures, found similar outcomes between actual surgery and simulated surgery, which replicates certain aspects of the procedure without performing the specific surgical maneuver being studied. ⁹ The small number of studies and the diversity of procedures limit the generalizability of these findings. This result does not mean that all surgeries are unnecessary.

Lorsque vous ajoutez une activité, augmentez progressivement sa durée ou sa difficulté selon votre réponse. Par exemple, évitez de transformer soudainement une courte course habituelle en très longue sortie. Une étude de 5 205 coureurs a associé les sorties nettement plus longues que la plus longue sortie des 30 jours précédents à davantage de blessures¹⁰. Elle ne définit pas une progression garantie sans risque. Notre article comment commencer la course sans se blesser donne un exemple de progression.

Platelet-rich plasma injections use a preparation derived from your own blood. The blood is processed to concentrate the platelets—small blood cells that help stop bleeding—and the preparation is then injected into the target area. A study published in the New England Journal of Medicine followed 80 athletes with hamstring injuries—the muscles at the back of the thigh. Both groups received the same rehabilitation. The group treated with platelet-rich plasma did not return to sports any faster than the group receiving a saline injection without any active ingredient: in each group, half of the participants had returned to sports within 42 days. ¹¹ This result applies to these recent muscle injuries and this specific protocol.

La Clinique du Coureur propose un outil pour comprendre la quantification du stress mécanique, c’est-à-dire le dosage des forces appliquées aux tissus pendant les activités¹².

Our guide explains what to do if you get injured while running.

Our tips on returning to sports after an injury will help you prepare to get back into it and reduce the risk of a recurrence.

References

1. Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-1982.↩ Back to text: 1st, 2nd mentions
2. Coste J, Delecoeuillerie G, Cohen de Lara A, Le Parc JM, Paolaggi JB. Clinical course and prognostic factors in acute low back pain: an inception cohort study in primary care practice. BMJ. 1994;308(6928):577-80.↩ Back to text
3. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (ICHD-3). 4.5.2 Headache attributed to ingestion or inhalation of a cold stimulus.↩ Back to text
4. National Health Service (NHS), Royaume-Uni. Headaches.↩ Back to text
5. Zadpoor AA, Nikooyan AA. The relationship between lower-extremity stress fractures and the ground reaction force: a systematic review. Clin Biomech (Bristol). 2011;26(1):23-8.↩ Back to text
6. Gao B, Dwivedi S, Milewski MD, Cruz AI. Lack of Sleep and Sports Injuries in Adolescents: A Systematic Review and Meta-analysis. J Pediatr Orthop. 2019;39(5):e324-e333.↩ Back to text
7. Wills AK, Ramasamy A, Ewins DJ, Etherington J. The incidence and occupational outcome of overuse anterior knee pain during army recruit training. J R Army Med Corps. 2004;150(4):264-9.↩ Back to text
8. Neal BS, Lack SD, Bartholomew C, Morrissey D. Best practice guide for patellofemoral pain based on synthesis of a systematic review, the patient voice and expert clinical reasoning. Br J Sports Med. 2024;58(24):1486-1495.↩ Back to text
9. Louw A, Diener I, Fernández-de-Las-Peñas C, Puentedura EJ. Sham Surgery in Orthopedics: A Systematic Review of the Literature. Pain Med. 2017;18(4):736-750.↩ Back to text
10. Schuster Brandt Frandsen J, Hulme A, Parner ET, Møller M, Lindman I, Abrahamson J, et al. How much running is too much? Identifying high-risk running sessions in a 5200-person cohort study. Br J Sports Med. 2025;59(17):1203-1210.↩ Back to text
11. Reurink G, Goudswaard GJ, Moen MH, Weir A, Verhaar JA, Bierma-Zeinstra SM, et al. Platelet-rich plasma injections in acute muscle injury. N Engl J Med. 2014;370(26):2546-7.↩ Back to text
12. La Clinique du Coureur. Quantification du stress mécanique (QSM).↩ Back to text

Nos physiothérapeutes ont défini la stratégie de recherche, le plan et le contenu clinique de cet article. Un outil d’IA a soutenu la recherche documentaire et la révision du texte pour assurer une cohérence du contenu et du style d’écriture.