A four-minute explainer for families who have been told the tests came back normal.
Watch first: Dr. Rachael Coakley explains the difference between acute and persistent pain, using the fire-alarm model families hear in the workshop.
What the video covers
- 0:00 — What pain is for, and why acute pain is useful
- 1:10 — What changes when pain lasts longer than healing takes
- 2:25 — The fire-alarm model, and why sensitivity is not exaggeration
- 3:20 — What actually turns the volume down
Why “the tests came back normal” isn’t the end of the conversation
Most families arrive here after a long run of appointments that found nothing. That result is real and it is good news — but it is often delivered as though it settles the question, and it doesn't. A normal scan tells you there is no new injury. It does not tell you why it hurts.
Persistent pain is a problem with the alarm system, not with the building. The nerves that carry pain signals have become better at their job than anyone wants them to be. That is a physical change, it happens in real tissue, and it is measurable.
What to say afterwards
Families tell us the hardest part is not understanding this themselves — it is repeating it to a school, a coach, or a relative. Two sentences that tend to work:
- "The pain is real. The tests are normal because the problem is in how the signal is being sent, not in the tissue."
- "We're treating it, and the treatment is skills and pacing rather than a procedure."
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Lorem ipsum dolor sit amet, ut impedit repudiare eam, te omnium mediocrem has. Mea cu unum inermis honestatis. Eos no illum omnium, no usu urbanitas vituperatoribus. Est probatus liberavisse te, eum recteque scribentur et, ex vel ridens aperiri mediocritatem. Pro ex tollit electram, mea cu inermis repudiare persecuti.
Lorem ipsum dolor sit amet, ut impedit repudiare eam, te omnium mediocrem has. Mea cu unum inermis honestatis. Eos no illum omnium, no usu urbanitas vituperatoribus. Est probatus liberavisse te, eum recteque scribentur et, ex vel ridens aperiri mediocritatem. Pro ex tollit electram, mea cu inermis repudiare persecuti.
Lorem ipsum dolor sit amet, ut impedit repudiare eam, te omnium mediocrem has. Mea cu unum inermis honestatis. Eos no illum omnium, no usu urbanitas vituperatoribus. Est probatus liberavisse te, eum recteque scribentur et, ex vel ridens aperiri mediocritatem. Pro ex tollit electram, mea cu inermis repudiare persecuti.
Lorem ipsum dolor sit amet, ut impedit repudiare eam, te omnium mediocrem has. Mea cu unum inermis honestatis. Eos no illum omnium, no usu urbanitas vituperatoribus. Est probatus liberavisse te, eum recteque scribentur et, ex vel ridens aperiri mediocritatem. Pro ex tollit electram, mea cu inermis repudiare persecuti.
Lorem ipsum dolor sit amet, ut impedit repudiare eam, te omnium mediocrem has. Mea cu unum inermis honestatis. Eos no illum omnium, no usu urbanitas vituperatoribus. Est probatus liberavisse te, eum recteque scribentur et, ex vel ridens aperiri mediocritatem. Pro ex tollit electram, mea cu inermis repudiare persecuti.
Lorem ipsum dolor sit amet, ut impedit repudiare eam, te omnium mediocrem has. Mea cu unum inermis honestatis. Eos no illum omnium, no usu urbanitas vituperatoribus. Est probatus liberavisse te, eum recteque scribentur et, ex vel ridens aperiri mediocritatem. Pro ex tollit electram, mea cu inermis repudiare persecuti.
Lorem ipsum dolor sit amet, ut impedit repudiare eam, te omnium mediocrem has. Mea cu unum inermis honestatis. Eos no illum omnium, no usu urbanitas vituperatoribus. Est probatus liberavisse te, eum recteque scribentur et, ex vel ridens aperiri mediocritatem. Pro ex tollit electram, mea cu inermis repudiare persecuti.
