Muscle Strain Recovery and Pain Response

I’m going through a muscle strain recovery right now on my piriformus. It’s been brutally persistent with the pain due to use of the muscle. I had a similar issue with an intercostal muscle about 6 months ago. This is what got me wondering about the difference between pain from an actual tissue injury vs central sensitization occuring after the muscle has healed.

What I’ve noticed is that the pain is usually in a particular area, but sometimes will travel around the hip, or rib cage in the other case. This seems like my mind playing tricks on the actual location. Also, the pain will be there on the first rep, then completely gone on subsequent reps. Again, this seems like more of a sensitization vs actual injury. Then it will be back to the same for the next work set.

My doctor has given me a high dose of NSAID to help with the initial inflammation. However, the pain seems to linger for many weeks, at least 8. I continue to train, but with a reduced weight/ROM, then slowly working back up to normal. I go as far as I can while keeping the pain at or below a 2-3/10.

My question is how do you tell when the initial strain has healed and the rest is due to just central sensitization, if that is really what’s going on? Could you tell by doing a blood test for inflammation? I’m seriously beginning to think this is a mental remnant of the original injury. Or does it really take this long for a muscle strain to heal?

Hard to say, schmatt. This is what loads of ongoing research is looking into. No, you can’t tell from a blood test for inflammation. The best things you can do are 1) Educate yourself about pain (which it appears you’ve already started to do, at least) and 2) Keep moving and training, ideally in ways that don’t exacerbate your pain.