Pain continued:

What is in your cup?

The pain cup in another analogy for describing pain perception. In the previous blog we defined pain which may be associated with potential or actual tissue damage. The analogy that pain is the ‘alarm system’ of your body to ensure that we are protected from potential harm either physical, social or psychological in nature.

The water cup analogy adapted from Greg Lehman

Overflowing pain cupThe over flowing water cup analogy describes our body as a cup, with many factors that may drive your sensitivity to suddenly increase and fill up the cup. New or current stressors can be biological, social or psychological in nature that can tip us over the edge and spill our cups, where potential pain may emerge.

When stressors in our life exceed the space in our cup’s capacity, we may have pain.


Potential pain contributor examples:

  • Joint changes
  • Joint chemicals
  • Fear of movement
  • Poor sleep
  • Lack of support
  • Anxiety
  • History of pain
  • Habits

Everyone’s water cup threshold is different and we want to understand what individualised stressors make your cup overflow.

Ask yourself:

  • What is in your cup? (The potential contributors to pain)
  • What am I willing to change or address what’s in my cup? (You do not have to address all stressors to help calm things down)
  • How can you build a bigger cup? (To build your resilience to potential stressors)

Pain may occur when we do not adapt positively to stressors in our every day life. The good thing is stressors aren’t fundamentally bad as they allow our bodies to cope better as we gradually expose our bodies to these stressors. Hence there are different approaches that we can take to either calm things down or build them back up.

Pain overflow factors

Changing pain:

  • Which stressors are you willing to change?
  • During your consultation we will work on strategies to help you manage your pain and stressors

Strategies to calm pain down may include:

  • Education and reassurance
  • Activity modifications
  • Avoiding activities that flare you up for multiple days
  • Manual therapy (dry needling, massage, mobilisation)
  • Medication (antiseptics, antibiotics etc)

Podiatrist assessing pain

Building up you cup:

  • Improve mood
  • Improve coping mechanisms
  • Better sleep hygiene
  • Individualised load program

Some conditions may need more specific management strategies compared to others


An ingrown toe nail spicule (spike) may need to be removed before skin tissue healing can occur over using excessive amounts antibiotics if there is not infection.


For an Achilles tendinopathy you may benefit more from calf raises to build up strength rather than swimming.


If you are interested in building up your cup, calming things down in your cup or any podiatry related questions feel free to contact

Post by: Podiatrist Richard Ching