Personal Pain Management

 

Thanks to Dr. Andrew Wheeler, DPT for sharing all his great information!

 

 

What Is Pain?

  • Pain is a negative sensation caused by noxious stimuli that is registered by the brain which was relayed from receptors externally or internally from the body.
  • Pain is tolerated differently by every person, but it’s method of travel is consistent for every person.
  • The painful stimulus  disturbs the  nerve endings sending the pain signal to an afferent nerve. The afferent nerve relays the signal to  spinal cord which in turn, sends the message to the brain.
  • The painful stimulus  disturbs the  nerve endings sending the pain signal to an afferent nerve. The afferent nerve relays the signal to  spinal cord which in turn, sends the message to the brain.

 

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The painful stimulus  disturbs the  nerve endings sending the pain signal to an afferent nerve. The afferent nerve relays the signal to  spinal cord which in turn, sends the message to the brain.

 

 



Determining What Type of Pain You are Experiencing

    Acute Inflammatory Soft Tissue Pain:

–      Often area is Hot, Red, Swelled or Bruised.

–      Recently happened.

–      Tender to touch area.

–      Moving or touching area is painful no matter position.


    Chronic Inflammatory Soft Tissue Pain:

–      Painful area “aches” and may or may not be constant throughout day.

–      Most likely will not be swollen or warm.

–      Has last for 3 months or greater.

–      Pain is difficult to pin-point on body.

–      Pain is referred from one area to another.


    Acute Mechanical Pain:

–      Recent onset with or without know cause.

–      Pain goes away or is greatly improved with different positions of body and or specific joint.

–       Pain sensation can be reproduced over and over depending on body or joint position.

–      Pain is intense and nagging.

–      Muscle spasms or trigger points may be present following initial onset.


    Chronic Mechanical Pain:

–      Onset of pain is 3 months or greater.

–      Pain goes away or is greatly improved with different positions of body or specific joint.

–      Pain sensation can be reproduced over and over depending on body position or specific joint.

–       Pain is less intense and nagging.

–      Muscle spasms or trigger points may be present.

 

 

Types of Injuries and Their Classification

  • Mechanical injury pain:

–      Vertebral disc herniation

–      Vertebral dysfunction.

–      Joint subluxation.

–      Joint dislocation.

–      Bone to bone contact.

 

  • Inflammatory soft tissue injury pain:

–      Blunt trauma

–      Ligament sprain

–      Muscle strain

–      Dural tightness (nerve pain)

–      Bursitis

–      Tissue infection

–      Wound site (surgical or traumatic)

 

 

One Pain can Lead to Another

    Mechanical sources of pain often leads to soft tissue inflammation.

–      Ex. Bone to bone contact can lead to an inflammatory response causing swelling which irritates surrounding nerve tissue, causing muscle tenderness, spasms and tightness.

–      Ex. Vertebral disc dysfunction can lead to spinal ligament irritation which excites surrounding nerves, causing muscle trigger points and spasms.

 

Lets Get Some Pain Relief

    First response to acute pain (any type).

–      P.R.I.C.E:

  • Protect or immobilize area from further injury. Avoid painful movements. Pad area with protective material if able.
  • Rest injured area for as long as possible.
  • Ice injured are for increments of 15 to 20 minutes. Allow 15 minutes in between icing sessions.
  • Compress injured area with elastic bandage (if possible) for 1 to 2 days.
  • Elevate injured area (if applicable) above heart level as much as possible.
  • First response to acute pain (any type):

–      R.I.C.E:

  • Rest area in pain.
  • Ice area in pain using 15 to 20 minute sessions allowing 15 minutes between sessions.
  • Compress area using elastic bandage for 1 to 2 days.
  • Elevate area when applicable.

 

Combatants of Pain

    Heat Vs. Cold a Battle Royal.

–      Heat

  • Raises local tissue temperature.
  • Increase local blood flow which can remove pain inducing inflammatory chemicals.
  • May relax muscle response to stimuli.
  • Can increase inflammatory chemicals causing increased pain.
  • Can increase bacterial replication during active infection.
  • Cold

–      Decreases local blood flow which can minimize inflammatory chemical response.

–      Numbing effect to skin surface and superficial musculature.

–      Can disrupt pain gait signals.

–      Does not support bacterial replication.

 

Heat Vs. Cold

  • Heat therapy should only be used for pain relief when the site of injury is no longer in an inflammatory state.

–      3-4 wks after a surgery that was not complicated by infection.

–       Arthritic joints not in an inflammatory state.

–      Sore and/or tightened muscles 3-4 days after initial strain.

 

Cold Vs. Heat

  • Cold therapy can be used at any stage of healing following an injury. Cold therapy should be used with caution in individuals who have a low tolerance for cold or have a diagnosis of Raynaud’s disease.



Proper Posture
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Stretching

  • Tendon and joint capsule stretching should last 5 minutes or more to improve extensibility of the tough, fibrous tissue.
  • Nerve stretches (dural stretches) should be conducted slowly and progressively lasting at least 30 seconds.


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Exercise and Activity

  • Always be evaluated by a physician before engaging in vigorous exercise program. A bi-yearly exam should be scheduled regardless of activity levels.
  • Exercise and physical activity does NOT have to be vigorous to benefit someone. Daily movement and activity outside of normal daily tasks is recommended.
  • Physical therapists specialize in developing exercise programs for people with multiple diagnoses.

 

Benefits of Exercise

  • Improved heart health
  • Improved peripheral circulation
  • Natural endorphin release (mood enhancement and pain depletion)
  • Bone density
  • Cartilage health
  • Decreased incidence of disease (ex. diabetes, cancer)
  • Blood glucose regulation
  • Facilitation of joint alignment

 

Physical Therapy Help and Access

  • A physical therapy consultation and treatment program can assist you with home pain relief, a diagnosis specific exercise program and future ongoing support for a overall healthy lifestyle.
  • Patients have direct access to PTs in 46 states including Washington D.C. (Oklahoma, Michigan, Indiana and Alabama do not). Although, a team effort is always the best approach.
  • Approaching your physician with specific goals for pain relief or fitness improvement can better assist them in referring you to a PT.



Modeling Stretches

 High Dive

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Low Back Twist

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Straight Leg Raise

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Cannon Ball

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Straight Leg Cross

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Bow to the Queen

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Half Pipe

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Door Fall

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Supine Figure Four

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Quad Stretch

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Hammy Time

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Frogger

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