The PainSmart Principles:
An Overview

PainSmart Principles

“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. (peripheral and central sensitization)
  2. (peripheral and central nervous systems adaptive response and memorization of pain experiences)
  3. Opiate use causes Nervous System sensitization (
  4. Wind-Up. The effects of not fixing your pain is more pain, fear, isolation, and depression. (


Adorable bunny

The Principle of Problem Multiplication

Now that you have a deeper understanding of The Pain Tunnel, you need to understand The Principle of Problem Multiplication. This principle states that, one tiny problem, if allowed to exist for longer than a few months, will multiply into many, big, hairy problems, each requiring their own treatment. Let’s unpack this a bit. Let’s say you sit for work and you haven’t been intentional about keeping your butt muscles strong. That will lead to one tiny problem in the way you walk.

Read More
bunny rabbit

The Pain Tunnel: Part One

Before we can understand neck pain, we need to get a better grasp of the problem of pain. It requires us to take a journey into the inner workings of our perceptions. Hang in there with me and follow me down the rabbit hole. We perceive pain. It seems pretty straight forward. We can feel it. We can’t ignore it. It’s just there eating away at our souls. Those things are all true but the nature of the problem of pain is a bit more complicated. To make this easier to understand I’m going to describe it using another one of our senses.

Read More
illustration of a tunnel

The Pain Tunnel: Part Two

Being in unending chronic pain is like falling down a dark well. You feel alone in the darkness, hurting, terrified, and you don’t know if you will ever get out. You can’t see the walls of the well so climbing out seems impossible. You just feel hopeless. In Part 1 of this series, I deepened your understanding of the nature of chronic pain and I introduced you to The Pain Tunnel. If you haven’t read that you can do it here. Understanding The Pain Tunnel gives you a map of the well. Now I want to give you a flashlight so you can begin to see how to navigate your way out.

Read More

The Baby Steps: Essentials

The Baby Steps: Essentials The Align Quick Start Guide   We have collected all of the primary information you need to walk through chronic pain inside of this Quick Start Guide. You will learn more about: The Pain Spiral Cycle, The Baby Steps, The Pain Smart Principles, and The Joint Function Scorecard. Download PDF  …

Read More