Chronic Pain, Part 2... Finding GOOD Help
Updated: Aug 10
I've seen MANY physical therapists/massage/chiro/acupuncture/osteopaths. Some helped, some didn't. Why? Even though their professions are mainly about helping people in pain, they themselves are not trained in chronic pain. And it creates a huge gap.
Hindsight being 20/20, if I'd only known then what I know now... I've learned a lot, and I am still learning.
In the first post I talked about looking at how complex pain can be. Then asked the question if surgery/injections/drugs are really the answer.
There has been much research looking into the numbers of actual benefit of surgery[1]/injections/drugs[2] and even all of the imaging (MRI, ultrasound, x-ray) that is done with chronic pain. And to be honest, there is not much evidence showing surgery/injections are more beneficial than properly prescribed movement/exercise. We'll talk about that next week.
Chronic pain is a tough place to be and all you really want is an answer and a clear path to recovery. But it isn't that easy, as you could see in the diagram in the last post, pain is complex.
So where does that leave you? Sadly for most, trapped in the medical system that only tends to look for structural, or as they call it, biomedical reasons, as that is how they have been trained. But there is another side... the psychosocial aspect.
Think about how pain has affected your life?
Have you changed how you live?
Have you stopped doing certain activities you loved?
Do you avoid social situations (for reasons other than Covid) because standing or sitting causes pain?
Does your pain experience make you so exhausted that you just don't have the energy to do things anymore?
I could ask you so many questions and I know we could have a full, lengthy conversation about it. But in all the questions that look at how pain now affects your life, what about how your life was just before pain? Was there stress? Was there a big change in your life? Was there conflict or unhappiness? Was there sleep deprivation?
These factors contributed to your pain, then the pain caused questions and fear, and with chronic pain, there is usually a good amount of fear. Fear of never feeling better, fear of constant pain, fear of moving your body, fear of waiting for answers, fear of a scary answer... And therein lies another post about chronic pain... the fear/pain cycle. Stay with me, it will be up soon!
So where does that leave you... in a rabbit hole of finding that one thing that will help, so we head to physio, massage, chiro, acupuncture... there are a whole lot of manual therapies that seem logical to work. But in all the go to therapies, do any of them help you look at your life and give you the tools to mentally work on the pain? If yes, then congrats! I would love it if you can share your practitioner's name so I can add it to my network list of good, solid manual therapists. But unfortunately there are not many out there.
Know that a good physical therapist is going to do a few things:
Talk to you about your goals.
They will look for red flags and refer you to the medical community when needed.
Help you find patterns that cause flare ups in your pain, not often are they movement patterns.
Give you tools to deal with pain when it flares up at 3am.
Help you look at the big picture of pain.
Provide some education around how pain works, it is more than just tissue damage.
And... they are going to get you moving your body. Providing the right level of movement that will help you build your path to wellness.
A few red flags for you to look for when working with a physical therapist:
They tell you chronic pain will not go away and that you'll have to learn to live with it.
That medication or a surgical procedure is your best bet and should be tried before anything else.
That your pain is due to 'poor posture', asymmetry in your body, or weakness in a specific muscle.
That you need to rest and avoid certain (or all) movement/exercise.
And they want you coming back to them frequently for them to do all the work on you.
Does any of this resonate with you? It can be tough, everywhere we turn, and how we grew up, we are told that pain is structural (or sometimes we are told it is ONLY in our heads), and that the only fix is surgery/injections/medication and there is no talk about what is going on in the rest of our lives. It makes me want to scream!
Let's change this! Starting here, look at the app Curable, do some reading on the P in psychological, and explore your big picture.
Interested to see where you are in the range of pain management?
Or maybe your level of kinesiophobia (fear of moving your body)?
Want to learn more? Click on the next post, or contact Amber and talk about it.
2. Opioids compared to placebo or other treatments for chronic low-back pain