I read the book �Explain Pain� this week and I have a better understanding of these theories. To answer biffnoble's question, part of what these theories say is that not all pain is caused by tissue damage. Once the nervous system becomes dysfunctional, you can do things that are not aggravating the underlying organic pathology but still cause real physical pain because your nervous system is not processing information correctly.
I've asked my physical therapist about this issue of pain free movement versus consequence free movement because I also was doing home exercises while using significant painkillers. The answer I got from one of them was that a small increase in pain later that quickly resolves is not a problem but if I was doing my exercises in such a way that I had significant pain afterwards that I was doing too much.
There was one exception to this rule, which is muscle soreness from strengthening weakened muscles. That was to be expected and isn't a problem. But I think you can easily distinguish that kind of pain from other kinds.
Re natasha remarks, I'm all for people trying Sarno's approach since for some people they get great results. However he puts off a lot of people and it doesn't work for everyone.
The point of my remarks about Sarno is that you may be able to get an improvement in your pain by doing the things Sarno suggests i.e. adequate pain medication, graded aerobic activity, and learning about pain that is not protective, without necessarily believing in his theories about unconscious rage causing pain or the idea that back pain has no organic cause most of the time.
Beliefs about pain do affect your pain levels in a objective physical way. I saw a functional MRI study by one of the authors of this �Explain Pain� book where they found simply explaining the neurophysiology of the pain (including these theories of nervous system senstation) to a patient with back pain reduced activity in the areas of the brain related to pain during back exercises. There are similar studies showing the effect of anticipation of pain and belief that you have some control over your pain affecting your pain levels. Obviously if you have a severe organic problem, changing your beliefs won't eliminate your pain, but I find it interesting that it can at least modulate your pain.
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