There's a phenomenon I see repeated every week that rarely gets named clearly: the fear of movement. Technically it's called kinesiophobia, but in practice it looks like this: the patient comes in with pain, receives a diagnosis, and leaves with fear.
The doctor says "you have two herniated discs" or "your knee is quite worn down" and the patient hears something completely different: *I shouldn't move, any movement will make it worse*. I had a patient who for two years avoided bending his trunk to pick things up off the floor. Two years. Because the doctor said his spine was "compromised" and he interpreted that as a sentence of immobility.
From there the cycle installs itself. Muscles atrophy, the spine loses support, the pain increases, the fear increases too. And it was the healthcare system that started all of it with a poorly chosen phrase in a ten-minute appointment.
Treating chronic pain without addressing this fear is almost always pointless. The patient does the exercises with their body, but their mind is constantly saying *careful, it's going to hurt, stop*. While that's happening, the nervous system stays on alert and the pain goes nowhere.
The pain education the article mentions isn't a leaflet in the waiting room. It's a long, repeated conversation where you explain that feeling pain during movement doesn't mean you're causing damage. That distinction, pain does not equal harm, is probably the most liberating thing you can say to someone with chronic pain. And it takes months to be truly believed. With that patient it took almost a year.
One point that deserved more space: women don't just have a higher risk, they're also the ones whose symptoms are most frequently minimized or attributed to anxiety before receiving an adequate diagnosis. The average time to diagnosis for endometriosis is seven to ten years in many countries. That's not just a failure of the system. It's a cultural failure that turns treatable pain into entrenched chronic pain.