Good Pain vs. Bad Pain: How to Read Your Body’s Pain Signals

You finish a tough leg day and can barely walk down the stairs the next morning. You’re 32 weeks pregnant and rolling over in bed makes your pelvis ache. You’re six months postpartum and your back still hurts every time you lift your toddler.

All three are “pain.” But they are not the same thing, and they don’t call for the same response.

As an orthopedic clinical specialist and pelvic health physical therapist, one of the most common questions I hear is some version of: “Should I push through this, or should I stop?” The answer starts with understanding what pain actually is.

What Is Pain, Really?

That distinction matters. Pain is your brain’s interpretation of signals coming from your nerves, and that interpretation is shaped by much more than the tissue itself. Stress, sleep, previous injuries, nervous system sensitivity, and your recent workload all influence how much something hurts.

This is why two people can stub their toe in exactly the same way and respond completely differently. One takes a breath and moves on. The other is in tears. Think of a young child who stubs their toe: their nervous system hasn’t yet learned that the injury is over and they’re going to be okay. As adults, we usually recognize that the stimulus has stopped, calm our nervous system, and carry on.

Pain is information. When you touch a hot stove, pain makes you pull your hand away. That’s your body protecting you, and that’s a good thing. The goal is not to fear pain, but to learn how to interpret it.

What Is “Good” Pain?

Good pain is discomfort that comes from building capacity. It’s intense, but it isn’t threatening. Examples include:

• Muscle fatigue and burning during effort, like the last two or three reps of a hard set
• General soreness after introducing a new exercise or workout
• A challenging stretch that feels intense but good, like a deep hamstring stretch
• Delayed onset muscle soreness (DOMS), which can last two to three days after exercise
• The discomfort of trigger point release or dry needling, the “hurts so good” kind

There’s also what I call purposeful pain: your lungs and legs screaming at the end of a hard race, or contractions during labor. Your body is telling you it’s uncomfortable, but you intuitively know this is something to lean into, not pull away from.

If you’re new to strength training, understanding this alone can change everything. Soreness after a new workout doesn’t mean you did something wrong. It means your muscles are adapting.

Labor Contractions: Pressure, Not Pain

Contractions are intense. But that intensity doesn’t mean something is going wrong.

Your uterus is a muscle, and during labor it’s doing incredibly purposeful work. Your cervix is changing. Your pelvis and pelvic floor need to relax and open so your baby can move down and through.

Here’s the problem: what do we naturally do in response to pain? We recoil. We tense up and pull away. That’s the exact opposite of what your body needs during birth.

That’s why I encourage women to reframe the language. Pressure, not pain. Intense, not hurt. When we change the words we tell our brain, it helps the body lean in rather than brace against the process.

If you’re preparing for birth and want support building this mindset (and the physical preparation that goes with it), the Holistically Well Pregnancy Program walks you through it.

What Is “Bad” Pain?

Bad pain is your body’s signal to pause and investigate. It doesn’t always mean panic, but it does mean pay attention. Watch for:

• Sharp, stabbing, or pinching pain
• Pain that feels unstable or threatening, or that you struggle to control your reaction to
• Pain that progressively worsens as you continue an activity
• Pain that changes how you move, like limping or altering your running form
• New numbness or tingling, which can signal nerve irritation or restricted blood flow
• Significant swelling alongside pain
• Pain that lingers or escalates after activity
• Symptoms that are becoming more frequent or more intense over time

Why Context Matters

In the clinic, I might have a patient with a history of SI joint pain try bridges with marching. If they feel it a little at first, I’ll often have them continue for five to ten reps. If the discomfort fades as they go, that’s a good sign: the body is learning the movement is safe. If it climbs from a 2 out of 10 to a 4 or 5, that tells me their body isn’t ready for that single-leg challenge yet.

Same sensation at the start. Completely different meaning based on what happens next.

The Traffic Light System for Pain

This simple framework is something you can use right away for yourself, your kids, or the athletes you coach. It isn’t a diagnosis, but it builds body awareness and helps you decide what to do next.

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Green Light: Keep Going

• Mild muscle fatigue
• Soreness that makes sense for what you did (sore quads after a day of squats)
• Symptoms settle within a day or two
• Movement still feels normal and your form doesn’t change
• Discomfort stays the same or improves as you continue

Green light means you’re applying the right amount of stress to create change. Continue and progress gradually.

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Yellow Light: Proceed With Caution

• Mild pain you’re unsure about, around a 4 or 5 out of 10
• Symptoms increasing during activity
• Soreness lasting longer than the expected two to three days
• Needing to modify how you move

Yellow light means hold steady. Don’t progress yet, and consider reducing the load until your body adapts to what it’s already doing.

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Red Light: Stop and Get Assessed

• Sharp pain
• Significant or escalating pain
• Neurological symptoms: numbness, tingling, sharp shooting, or burning
• A major change in function, like being unable to take stairs or needing to limp
• Symptoms that don’t make sense, like shoulder pain when you didn’t use your shoulders

Red light means stop and find out what’s going on.

Why Chronic Pain Gets “Stuck”

I recently had a woman message me about constant upper and mid-back pain. She stretches all the time, but nothing changes.

What’s often happening with this kind of persistent pain is muscle tension. Healthy muscle fibers lie nice and parallel, like uncooked spaghetti. Dysfunctional, tight muscles look more like cooked spaghetti poured into a pile: tangled and balled up. That tension puts constant pressure on nearby nerves, which send a steady signal to the brain that something hurts.

Over time, the body gets stuck in a chronic pain feedback loop.

Stress makes this worse. Poor sleep, a newborn, a loss in the family, a toddler with new night terrors: your body responds to stress by tensing up, which presses on nerves, which signals pain. Many patients are surprised their pain flared when “nothing changed” physically, until we talk about everything else going on in their life.

Breaking the Loop

Breaking the cycle takes two things:

1. Disrupting the physical stimulus. Techniques like dry needling, myofascial trigger point release, and cupping help tangled muscle fibers relax back toward their normal parallel alignment.
2. Changing what happens outside the office. If we only release the tension but nothing changes in your daily habits, stress, and movement, the tension comes right back.

That second piece is why physical therapy includes a home plan: tools to release and relax those muscles yourself, and exercises to keep them that way. If that sounds like what you need, book a 1:1 session with our team in Sidney, Ohio or virtually.