The PainSmart Principles:
An Overview

trainer working with middle aged woman

“You cannot break timeless principles. You can only break yourself upon them.” - Stephen Covey


The PainSmart Principles are the foundation of The Align Method.

These principles are timeless, unavoidable, and essential to understand if you are going to walk with wisdom in the area of pain. Any treatment not informed and guided by these principles is like shooting a gun in the dark. You don’t know what you are aiming at or what the long term consequences of taking that shot will be.

Each of these principles holds deep wisdom and an immense amount of scientific research. This blog is aimed at giving you an introductory knowledge of The PainSmart Principles, as well as a jumping off point for further learning. I’m proud of you for diving in to understand your body, your situation, and the nature of pain. Let’s jump!

Principle #1

The wise know joint dysfunction creates joint degeneration. The body is a machine and is supposed to work in a certain way. If it’s not working properly, the parts wear out faster. Your MRI results are caused by immobile, unstable, and insufficiently strong muscles and joints.

Principle #2

The wise know chronic pain is a collectively caused experience, not singular. Your pain experience is a combination of your joint dysfunction loading and grinding on your joint degeneration, the inflammatory reaction to that situation, and your central and peripheral nervous systems interpretation and memorization of the whole situation. The foolish think their MRI results and joint degeneration are the sole cause of their pain. The wise know that joint degeneration is important to be aware of and address when necessary, but that how your body is working, reacting, interpreting, and adapting to chronic pain is even more important.

Principle #3

The wise focus on identifying and fixing the underlying root causes of their pain problems. Pain is an early warning system that alerts you to a potential threat to the body. It is not the problem itself. The foolish focus on “making the pain go away” and treating the symptoms created by underlying root causes. If you focus on the pain and treat nothing but symptoms, you will never get out of pain.

Principle #4

The wise know in order to live a pain free life, muscle and joint mobility, stability, and strength, and a healthy, regulated inflammatory and nervous system are all required. If any of these are missing, the seeds of chronic pain are being sown.

Principle #5

The wise know The Basics of Joint Function and own The Basic Joint Maintenance Toolkit in order to maintain them. The foolish don’t know the basics of how their joints are supposed to work or what tools they need to maintain their body.


People who are PainSmart, and walking with wisdom, feel empowered, knowledgeable, and fearless.

They know where they are at. They know their next steps.

People who are lost in their pain journey, and who are ignorant of the PainSmart Principles, feel victimized by the symptom-management system and their doctors. They feel confused, fearful, and hopeless.

I spent a decade needlessly in severe back pain because I didn’t know these principles.

I don’t want that for you. I want you to walk through your pain journey with wisdom so you don’t have to be in pain a minute longer than is necessary. I want to teach you to be PainSmart.

That’s my heart's desire for you,
Matthew Lister - Founder of Align

Scientific Foundations For The PainSmart Principles

Nervous System

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750819/#S7title (peripheral and central sensitization)
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1084068/ (peripheral and central nervous systems adaptive response and memorization of pain experiences)
  3. Opiate use causes Nervous System sensitization (https://www.painphysicianjournal.com/current/pdf?article=MTQ0Ng%3D%3D&journal=60)
  4. Wind-Up. The effects of not fixing your pain is more pain, fear, isolation, and depression. (https://www.instituteforchronicpain.org/understanding-chronic-pain/what-is-chronic-pain/central-sensitization)

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