 As a physical therapist, I deal with pain on a daily basis in one form or another. Back pain,
shoulder pain, knee pain, neck pain, ankle pain... they’re all part of my daily experience. Pain is such a common experience for most individuals at some point in their lives, and yet the truth is that so many people don’t know the first thing about what pain actually is. Pain is mysterious, and for many of us, pain is actually completely and utterly confusing. I’d like to shed some light on the darkness, tackling the definition of pain one step at a time. For most of us, pain is a very common part of our lives. We stub our toe, scrape a knee, or get our finger caught in a door. While it’s certainly uncomfortable, these types of pain aren’t necessarily pointing to a problem. What makes pain such a mystery is that it tends to surface in odd ways, at odd times, and sometimes in completely odd places. And yet, there is an explanation for this: our bodies are telling us that something is wrong, but not necessarily what is wrong. Let me explain. When we feel pain, our bodies are sending signals to the brain from the area that just got hurt. If you cut your finger, for example, your brain gets told about it and your finger is instantaneously sore. Similarly, if you scrape your knee, or stub your toe, it’s fairly easy to gather information about what happened. But what about when you have chronic back pain, for example? Did you know that the area of the brain responsible for pain gets bigger when it becomes chronic? This is called central sensitization. In other words your body starts misinterpreting the information and paints worse picture than it actually is in reality. Now if you add fear and anxiety on top of the chronic pain you have yourself a perfect storm. It is precisely this ambiguous nature of pain that is such a big problem for most of my patients. On a daily basis I hear, “I just don’t know what I did”, or, “I really can’t remember hurting it”. Pain is so frustrating in this way – if you only knew why it’s sore! The truth is, it’s difficult to figure out what your body needs from you – did you pull a muscle, damage the cartilage, or just sit in an odd position? We often can’t know for sure, at least initially. One thing remains certain, however: pain indicates a problem. When you cut your finger, the tissue is damaged and your body signals the brain so that something can be done to repair it. In the same way, if your back or knee hurts, something isn’t quite right and the body is trying to tell the brain to repair the damage. In the latter example, it’s just that the answer isn’t as clear. Despite this, though, both scenarios require the painful area to be examined and rehabilitated. It’s clear to see that pain is a lot like your internal warning system. If it hurts, the chances are that something is wrong. In my clinic, I treat pain as the symptom of an underlying problem. You may be feeling pain on the right side of your lower back, however the cause may be in the left hip. This is very common. By approaching pain in this way, I make sure to find the root cause of he problem so as to clear up the tenderness and discomfort. Sadly, for many medical professionals, dealing with pain is something that is done back to front. Painkillers and injections are prescribed to mask the pain in the hope that the discomfort will ease in time. In my experience, this just doesn’t work. The way we need to approach pain is NOT as a cause of discomfort, but as a SYMPTOM of a particular problem, whether it’s big or small. The mystery surrounding ‘pain’ is often worsened by the medical industry’s inability to treat the root cause of the problem. Instead, many medical professionals seek to get rid of the pain WITHOUT healing the source of the discomfort. It’s completely counterintuitive. That’s why physical therapy is by far the best way of dealing with gnawing, frustrating, mysterious pain: we find the root cause of the problem, heal it, and ensure that you maintain a pain free, active lifestyle. We all have to deal with pain in one form or another, but remember, one universal truth remains the same: treat the cause to get rid of the pain. Your body knows exactly what’s best for you, and the greatest thing you can do for it is to give it the benefit of the doubt. A pain free life is possible!
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 Photo by Joyce McCown on Unsplash My patient, Janet (name has been changed to protect privacy) has been struggling with back pain for years. One day she was reaching for her keys and her back went out. Every time she moved she felt an electrical shock go up her spine. The pain was so bad she had to call in to work. Next, she crawled over to the sofa and dialed the number to her doctor. Unfortunately the first available appointment was in 3 weeks. By then her back was slightly better, but she still couldn’t sit for more than 5 minutes or walk longer than 10 minutes. She was miserable.
The doctor’s office visit took less than 15 minutes. She was given some pain pills and a script for physical therapy. She was back to work, but going to Zumba and picking up her 3 year old daughter were completely out of question. Sounds familiar? I hear a similar story several times a day. Most people have or will experience back pain in their lifetime. I will share 3 secrets you need to know when dealing with back pain. First, don’t wait so long. Come and get your back treated as soon as you can. The sooner you receive physical therapy the faster we can get you feeling better. Here, in Colorado, we have direct access, which means that you can be seen by a physical therapist without a referral from your physician. We are trained to evaluate and treat back pain. We are also trained in differential diagnosis. This means that if your pain is caused by something other than a musculoskeletal issue we will refer you to a specialist. Janet could have saved herself 3 weeks of misery if she knew about it. As you know our spine has 3 curves: lower back, upper back and neck. Spine is like a pearl necklace, every vertebrae is supposed to move independently of each other. When you tweak your back, your muscles go into a spasm, the surrounding tissues become swollen and irritated and every movement becomes painful. Pain is your body’s signal that something is wrong. You can barely move, but you have to go to work, so you pop some pain pills and off you go. Now you are shifted to one side, nothing feels natural anymore and you start compensating by using muscles the way that they are not supposed to be used and create a secondary injury. So the sooner you get it treated, the sooner we can break this cycle and the faster you will be back to your normal routine. Second secret is restoring neutral alignment of the spine, which I refer to as the neutral. If one of the three spinal curves is bigger or smaller than it is supposed to be, or if you are creating an extra curve because you are shifted to one side, the compression on the spine, discs and surrounding tissues is increased which means you are causing yourself more pain. The 3 curves have to be in correct places for the muscle spasm to stop. When you are in neutral there is no pain. The muscles can relax, the swelling can decrease and you may just be lucky enough to get yourself out of the pain cycle. Try sitting up on the edge of your chair. Try leaning forward just slightly. There will be a place where you will have no pain. If you lean forward too much or too little it will hurt. It has to be just right, and pain is your guide. As you shift your pelvis forward you will notice that your head is going to move back. I encourage you to explore this concept. At a certain point you will notice that your neck is long and your jaw is relaxed. Congratulations, this is your neutral. The third secret is Pilates. Joseph Pilates came up with a brilliant system of exercises that teach you how to find neutral spine alignment. When you do Pilates exercises you are able to access the muscle memory of correct pain free movement. This concept of neutral is reinforced during all exercises so eventually it becomes second nature. Yes we can get you out of pain with massage, dry needling and other bodywork tricks we do, but Pilates is the long term solution. During the exercises you are able to strengthen and stretch at the same time. You will feel lighter, taller and have less pain. So there you have it. Three secrets of managing back pain. Come see your PT as soon as you can, find your neutral spine and strengthen your core with Pilates exercise. Check out our Free E-Book on 8 Natural Ways To Ease Your Back Pain Without Medication Or Visits to Doctor's Office. |
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