Here’s a situation for you:
Have you ever woken up in the morning with a new pain in your neck and thought “how the heck did this happen?”.
You go throughout your day and you feel that neck pain throughout the morning, your routine seemingly interrupted every few seconds because of this crick in your neck. Driving becomes more difficult because you can’t turn your head without pain. You go throughout your day, whether at work or home, and the pain just seems to get worse. The pain is getting more annoying by the minute, and you head to bed with hopes that it’ll be better tomorrow. But it’s not. In fact, when you wake up the next day, it’s actually worse. This cycle continues endlessly, it seems.
This is a very common situation for a lot of people, with pain that just comes out of nowhere. This cycle of pain can also occur with people who experience an injury that causes their pain. The management of pain, whether from a known or unknown origin, can be difficult, frustrating, and debilitating for some people.
At Remedy, we look at your situation and look to discover what is prolonging your pain. We look for events throughout your day that we call ‘triggers’.
Triggers can be anything that you do that causes pain. Previous clients of mine have heard this phrase many times before: “the more time you are in pain, the more time you are in pain”. Though this statement sounds obvious, how many people actually take this to heart? So many times, clients report to us that they are doing everything they can to improve their condition, but then they also tell us about all the activities that they are doing throughout the day that cause their pain. Every time you do something that puts you into pain, the more time (and probably longer time) you will have that pain. The management of a painful condition needs to incorporate a thorough review of everything you are doing during the day. Upon review, you could activating triggers hundreds of times a day without realizing it, and that doesn't allow your body to heal.
Here’s the science behind all of this:
When a painful tissue is used throughout the day, it sends signals to the spinal cord. At the beginning of a pathology, these signals go into a specific part of the spinal cord, the rexed lamina I. This allows these signals to be interpreted on multiple levels, sent up to the brain, and the brain gets to label these incoming signals as something painful/threatening or non-painful/threatening. Your brain get’s to make that choice.
Let me state that again: your brain gets to make the choice on whether or not an incoming signal should be painful or not painful.
One more time, for the people in the back: your brain gets to make that choice!
How cool is that? But we will circle around to that point in a minute. Back to the science: so if your brain interprets pain, you feel pain in that area. The more often that you trigger signals from a painful tissues, and the more that your brain interprets pain, you begin to see a host of changes. The area in which those signals go from painful tissue to spinal cord changes (rexed lamina I to rexed lamina V), as well as your body begins to grow more nerves in those areas. The body does this so that it can get more signals from that painful area. It’s a way for your brain to try and get more information. Here, the brain is thinking “if I can get more information from that area that is painful, maybe I can figure out what is going on.” But, more signals = more interpretations of pain = more pain being felt, as well as the person becomes more sensitive to painful triggers. The phenomenon is called sensitization.
Sensitization is mainly seen with allodynia and hyperalgesia, defined respectively as pain being caused from stimuli that don’t usually cause pain and increased pain experienced from a painful stimulus. In layman’s terms, the more sensitized you are, you begin to experience pain from movements/activities that don’t usually cause pain, and/or the movements/activities that cause your pain cause more pain than usual. Sensitization causes pain to spread, causes more nerve fibers to grow, and creates a cycle that continues to worsen itself over time. This cycle can affect your sleeping patterns, dietary habits, overall stress levels, and can lead to a host of changes to continue to influence and prolong this cycle. That’s why you’ll hear stories from people who have back pain that started as a small, mild pain, but now has evolved into a debilitating condition that even the smallest movements can cause a huge increase in pain.
But, there’s good news in all of this on how to break this cycle or stop it from even beginning, and it first leads us to circle back to the brain.
Remember, the brain get’s to decide what is painful/threatening and what is not. So if a signal from a injured tissue structure is not interpreted as painful/threatening, you will not feel pain. That’s why you see professional athletes come back quickly from injury; their brains are hardwired to interpret that competing in their sport is more important than sitting out with a painful injury. It’s really the major injuries - ACL tears, Achilles ruptures, broken clavicles, other torn muscles or ligaments - that trigger their brains to see their injury as threatening and something that is more important than their sport.
What plays into how your brain interprets the information you get? A whole host of criteria. These can range from fears, anxieties, joys, motivation, previous experiences, memories, your own opinions, opinions of others, etc.. In general, if you believe that your condition will improve and you pain will get better, that is typically what will happen. If you are in constant fear of your pain and you believe that things are going to get worse, typically that is what will happen. Your belief of you condition plays a huge factor in your therapy. At Remedy, we work to educate you on what your pain generator and what the steps will be to get you feeling better, because we believe the more information you have and the more you understand, the better chances you have of believing your condition will get better.
The other aspect of crushing the cycle of pain is to avoid those painful triggers. We work together to identify all of the triggers that are present in your lifestyle, because when you eliminate the triggers, you allow pain to decrease and for tissue healing to occur. Most all body tissues - when injured - will heal, but you have to allow those tissues the chance to heal. During our sessions, we can spend all the time in the world utilizing interventions to decrease your pain, but until all triggers are eliminated, we will not be able to achieve the results that you want.
Hopefully you gained a few knowledge bits from this post. If you have any suggestions for further posts, feel free to contact us at firstname.lastname@example.org. If you are having pain that you don’t know if you are managing well, schedule an appointment with us so we can work on getting you pain free quickly.
Welcome one, welcome all.
My name is Dr. Matthew Rysdyk, owner of Remedy Physical Therapy. I wanted to spend this first post welcoming you to the community. I look forward to working with you soon!
One aspect of the human experience is that we will all have physical pain at some point. Whether it's slamming your finger in a door, playing too hard with your kids in the pool, or having that pulled low back just trying to swing that golf club a little faster to get the ball to the green, pain is inevitable.
But, pain does not have to be indefinite.
Pain should not be indefinite, because when it is, a whole host of problems come with it. Looking at current research, the best understanding of pain that we have is this: pain is a product of the brain.
100% of the perception of pain comes from the brain. This means that each person has a pain experience that is different than another. If two people experience the same painful stimulus, Person A may feel less pain than Person B. Our perception of pain is influenced by so many factors in our life, it's hard to keep track of them all. For example, pain can be affected by stress, sleep levels, previous experiences with pain, prior treatments, social statuses, nutrition, activity levels, fears, anxieties, hopes, beliefs, etc. This list could probably go on forever.
That's why pain is no joke, and it should not be taken lightly. If pain is not managed well, someone with pain can creep into differing levels of sensitization, a phenomenon in the body where a person can become more sensitive to pain and other stimuli. Have you ever wondered why some people can deadlift 500+ pounds without an issues, but other people "throw their back out" when tying a shoe? Here's another one: how can some people have back pain for years after injury, while others are down for only a few days? Pain can be more complicated than you think.
And that is where I would like to come in. With my clinical doctorate in physical therapy, I am trained to help look at the murky waters of pain and help you figure out the best way to overcome it. Whether you've had pain for 1 day or 10 years, I can help you look at the triggers of your pain and assist you in eliminating them. You do not have to navigate through your pain alone.
Through this forum, I will help explain some of the fundamental ideas that make up my practice, why and how my philosophy is different than other physical therapists, and provide you with research-based information and education about different conditions to help you become more knowledgeable about varying aspects of orthopedic conditions.
Thanks for reading, and talk to you soon!