Painfully Speaking


Painfully Speaking



In orthopedics, it’s almost always the reason why patients seek our help. Pain may be the most difficult symptom to treat and for hundreds of years healthcare professionals have struggled with attending to the symptom of pain. The good news is progress has been made. We now have a better understanding of what pain is and how it affects individuals.


Let’s start with the basics. What is pain? Merriam-Webster’s Dictionary describes pain as “a basic bodily sensation induced by a noxious stimulus, received by nerve endings, characterized by physical discomfort (as pricking, throbbing, or aching), and typically leading to evasive action”. Wow, that was a mouthful, but what does all that mean? Simply put, “pain” is a normal reaction to something gone wrong in the body.  The first step in fixing the problem is to have a better understanding of pain.


Pain Is In Your Brain


If you put your finger over a candle flame, within a millisecond a nerve receptor transmits a signal from your finger up to your brain.  This signal basically tells the brain, “Hey, that’s hot! Move the finger!”, so that no further damage will take place.  That signal is sent back down to your finger, at which point you sense pain and remove your finger.  Receptors in the body, known as nociceptors, detect specific changes in heat, pressure and chemical changes to injured tissues in the body.  When those changes occur they deliver a signal to the brain, and the brain interprets and responds to the potentially harmful situation or injury.


Your brain works very hard to interpret these signals correctly, so you know when to move your finger and when things are safe.  And it doesn’t just work with this type of pain, these nociceptors are working 24 hours a day.  They are the things in your head telling you that you have done enough weightlifting for one day, that your new shoes are giving you blisters, that the way you sit at your desk is bad for your back, and that chili dog you had for dinner last night was a bad idea.  Think of your brain as Grand Central Station for pain signals. Pain is in your Brain.


Types of pain


There are many different ways to classify pain but for simplicity, the 2 major categories are Acute and Chronic.


Acute pain is a sudden response to a stimulus that is quick to resolve. An example would be the pain you encounter when you sprain your ankle for the first time.  Initially it can be very painful but as time passes, and as the injury heals, the pain dissipates. 


Chronic pain, on the other hand, will last much longer and might persist even after the injury has resolved. In these cases, your brain continues to receive signals that result in pain either due to a malfunction of those nociceptors or due to the misinterpretation of those signals in the brain. 


The ProEx Approach to Pain Management


Acute pain management is about controlling activities that can “worsen” symptoms. Often times it involves resting or immobilizing the injured area. This approach also incorporates the use of pain modalities (electrical stimulation or ice/heat) or manual therapy techniques such as massage and joint mobilizations in conjunction with physician prescribed pain medicines. In addition, range of motion exercises can be beneficial to increase circulation, decrease swelling, and decrease pain.


Chronic pain management tends to be a bit different. Dealing with chronic pain starts with a thorough explanation of pain so the patient understands pain and the expectations of treatment. In this approach, active involvement of the patient in the treatment is very important and the best way to combat chronic pain is by active movement therapy (i.e. exercise). The key is to use exercise like medicine where it is properly dosed and graded to stimulate healing (a physical response) and a sense of accomplishment for the patient (a psychological response). This approach of combining patient education about pain with prescribed exercise is the hallmark of the ProEx treatment philosophy.


To learn more about the ProEx treatment approach or to schedule an appointment to help manage your pain, please locate the closest ProEx clinic to you by clicking here:  (http://proexpt.com/content.php?l=66)

Painfully Speaking