In the past 20 years or so numerous research studies have changed the way we think about pain. How it works and how it should be treated. Unfortunately this research is not very well understood by the general public and even many medical providers. This misunderstanding of pain can lead to misconceptions on what is causing pain and making an appropriate plan to help pain. So here are 5 commonly misunderstood myths about pain. If you believe any of these about your pain, learning and understanding more about pain may give you a better path forward.
- Pain comes from a specific structure in your body, for example a joint, bone, or muscle.
- The amount of pain some is experiencing is directly related to the amount of structural damage or seriousness of an injury.
- Pain signals are sent from the body to the brain
- Pain is a completely physical experience, separate from thoughts or emotions
- Pain is in your head or psychosomatic if no physical injury or signs are present, for example negative scans or no obvious injury.
All of these are commonly held beliefs of people i have worked with in pain. These beliefs can greatly affect how we understand pain and how pain affects us. Over the next few posts we will see why these are myths and what that means for helping pain.
We will be speaking at Walking Mountains Science Center tomorrow evening December 10, 2014. This talk will be on The Science Behind Pain and gets going at 630 pm. Learn about how pain works and some ways to help. Hope to see you there.
Ascent PT is partnering With Walking Mountains School to present a lecture on The Science Behind Pain for theirScience Behind Lecture Series..This will happen at the Walking Mountains Center on Wednesday December 10 at 630…See the link below for more information.
Hope to see you there.
Here is the Understanding Pain video from Australia..subtitled in Spanish.
Earlier this summer we covered some of the ways pain and especially chronic pain works. Of course the question begs, “OK so…What do I do about it?”
To review, in chronic pain situations what can happen is the nervous system gets sensitized. An initial injury damages tissues, as a protective response, the brain sensitizes this area to guard it as it heals. In some people even as the tissue heals, the nervous system continues to stay sensitized or even becomes more sensitized. With this situation even normal movement can become painful reinforcing a situation of reducing function and continuing or increasing pain. So we have tissues that may be healed properly, and are perfectly safe to move, but because the nervous system is sensitized, pain continues to be produced.
Research has shown that a number of things can reduce the sensitivity of the nervous system. None of these are easy, and there are usually no quick fixes for chronic pain caused by a sensitized nervous system. Many people in this state have been there for months if not years. Many have had numerous medical opinions and failed treatments which can lead to fear and stress which also can sensitize the nervous system. It takes time and consistent effort but these following things have all been shown in research to reduce nervous system sensitization.
- Education: The first topic you have already started. Research has shown that learning about pain and understanding how it works can actually begin to reduce the fear and anxiety about it. This can start to turn down the system. Many people who have chronic pain have never been taught how pain works. And, they may have many misconceptions of how it works. This, along with multiple diagnoses and varying opinions on proper treatment, can lead to stress, fear, and anxiety, which all increase nervous system sensitivity. People have been given proper treatments of medication, exercise, manual therapies etc.., but because of poor understanding of pain, a comprehensive program is difficult to maintain. By understanding pain, people can see the logic behind treatment and can understand better what to do, why to do it, and how to do it. For more information on pain check out this page, https://ascentpt.wordpress.com/?s=pain+links for more detailed information, or seek out a therapist who understands therapeutic neuroscience education.
- Aerobic Exercise: Aerobic exercise is exercise that brings your heart rate up and is done steadily for an extended period, at least 20-30 minutes. Although if you have been in severe pain you may need to work up to this. Examples of aerobic exercise are walking, biking, swimming, or machines like an elliptical. Again research shows this is an effective way to ramp down the nervous system. Think how exercise can reduce mental or emotional stress.
- Graded movement/activity: This relates to aerobic exercise, but also incorporates other movements or household or work activities. Many people have seen their activity level drop significantly because of pain or fear of pain. A mistake they make is that they then attempt to jump back in to activity to vigorously after a long layoff, get a severe pain reaction, then avoid it. It is much more effective to start with a manageable level activity, whether it is a short walk, easy stretching, or limited household chore. When this is done without harm, the nervous system can accept it and slightly ramp down, and then you can steadily increase the level of activity. If the nervous system is turned up to 10 on a scale of 1 to 10 these activities will not drop it to 1 immediately, it will go to 9 then 8 then 7…We need to nudge it and tease it in the right direction.
- Relaxation/breathing: Deep breathing and relaxation techniques have also been shown to turn down the nervous system. This can take many forms such as learning and using diaphragmatic breathing, meditation, prayer, and yoga among other things. Taking time daily, or when pain is particularly strong to reset and relax the nervous system can be an effective way to move forward and calm your system.
These are 4 simple, although not always quick or easy responses, to calming a nervous system and gaining some control over pain. Many people get caught in a cycle of chasing answers that may not be there, fear and anxiety, and loss of hope and control. Living with pain on a daily basis is difficult and life altering. Finding ways to gain control of the pain can also be life altering in a positive way.
Our apologies for missing the previous 2 weeks of exercises due to some difficulty with the blog. This week, we will include 2 exercises. These exercises are both focused on improving knee flexion range of motion, or the ability to bend the knee.
The assisted knee flexion stretch is a more gentle way to improve flexion, and can be used when trying to regain this motion such as after surgery or injury. Sit in a chair and shift your weight forwards so that you bend the knee you want to stretch more. Use the opposite ankle to push the shin of the knee you are stretching further under the chair. Hold here.
The second stretch is a little more aggressive. On your hands and knees, rock your bottom back towards your heels, bending both knees. This should feel like a strong stretch, not sharp pain. Hold here.
As with all stretches, hold each of these a minimum of 30-60 seconds.
If you are unsure about whether you are ready for either of these, consult with your physician or physical therapist.
This is a good, easy way to improve your knee extension if you are unable to straighten it all the way. You should be able to extend the shin so that it is in line with the femur (0 degrees of flexion).
A simple way to improve your knee extension range of motion is as follows. Prop your heel up on a bolster, arm of a couch, or anything else that allows you to get the foot slightly higher than the hip. Let gravity straighten the knee for you. If you want a little extra, you can put an ankle weight on the tibia or the femur to increase the stretch.
Maintain this position, as long as you don’t have any pain with it, for at least a minute. Consult with your physical therapist or physician to determine if this is a good stretch for you.
Posted in Interesting things we can do in PT
Tagged ACL surgery, avon, Eagle, knee extension, Physical Therapy, Rehabilitation, Sports Medicine, straight knee, stretch, supine knee extension, Vail