The Saint John Method of Neuromuscular Therapy considers five principles that cause pain
 

  1. Ischemia is a lack of blood supply to the soft tissue, which causes them to become very sensitive to touch. Typically, if less than 5-10 pounds of pressure causes tenderness, the tissues are in an ischemic state. This is one of the first conditions a neuromuscular therapist analyzes. 
     
  2. Trigger points occur when nerves fire impulses at a rapid speed into an area of the body other than that which has been traumatized. Because of trigger points, the cause of serious pain may often be far removed from the actual site of the pain. This, in turn, inhibits proper blood flow, which causes ischemia and often leads to more pain and discomfort.
     
  3. Nerve compression or entrapment is pressure on a nerve by bone, cartilage or soft tissue. The role of the soft tissues in nerve compression is vital.. Realigning vertebrae without treating associated soft tissue frequently treats the symptom and not the cause. Spinal nerves are subject to intrusion when any of the vertebrae are dislocated or spinal disks herniated. Treating the surrounding soft tissues that cause or maintain the dislocation greatly enhances rehabilitation and alleviation of pain. 
     
  4. Postural distortion is an imbalance of the muscular system resulting from movement of the body off the coronal, midsagittal and horizontal planes. Gravitational force (33.5 lb. per square inch) is constantly pulling the body toward Earth. If there is an imbalance in the structural system, gravity causes the body to compensate in an effort to retain balance. Trauma, gravitational pressure or psychological patterning causes the soft tissues to assume a weight-bearing function and thus become thicker, denser and harder. Muscle contraction, body distortion and pain are the results of compensations the body makes in order to maintain structural homeostasis, By determining why the compensations have occurred, the distorted patterns can be eliminated, proper posture restored, and associated pain diminished or eliminated in most cases. 
     
  5. Biomechanical dysfunction is an imbalance of the musculoskeletal system resulting in faulty movement patterns. Repetitive strain of certain soft tissues results in adapted movement patterns that become muscular "habits" and must be reeducated.