VTS Physical Therapy
  • Home
  • About
  • FAQs
  • Testimonials
  • Contact
  • ASSESS YOUR PAIN

Breaking Bad

9/28/2015

0 Comments

 
Virus
In the last post, I wrote about the effect that words can have on how much pain we actually experience and how much our level of movement can be affected by it. Not only can the word choices that healthcare professionals use affect our pain, but also the words we tell ourselves. Pain scientists have called these words or phrases “thought viruses”. They are conversations we’re having with ourselves that actually “keep the pain state going” even though the tissues have healed. Some examples of these thought viruses are:

“This has been going on for so long, I’ll never get better.”

“The x-ray (or MRI or CT scan, etc.) didn’t show anything; this must be really rare and bad.”

“I’m afraid I’ll hurt more so I’ll just sit very still here on the couch.”

“I’m fragile, maybe even broken.”


Here are a few things you can do to start to break free of a persistent pain state:  

1. Pay it some Mind:  We’ve already talked about our most powerful ally in our fight against pain – the brain. Use it! When you catch yourself caressing your favorite thought virus, remind yourself to stop. Snap your fingers; clap your hands, switch your watch to the other wrist, etc., as a way to physically reinforce the mental change you want to accomplish. Then replace those negative phrases with more helpful alternatives, like:

“This may have gone on for a long time, but I will continue to be an active participant in finding a solution.”

“The fact that the MRI doesn’t show any major issues is really good. My joints and soft tissues are okay.”

“I feel weak and fragile, but there’s plenty of good, solid research that shows that a regular exercise routine can change that.”


2. Get moving: Over and over research proves that movement is imperative for the body to function properly. If you’ve been in pain for a very long time and, consequently, have been quite sedentary, consider a gradual return to regular physical activity. Gradual or graded is the operative word here. Care needs to be taken that one doesn’t do too much too soon. An example of graded activity may be the following: Set a timer for 2 minutes and take a walk outside or ride a stationary bike until the timer rings. That’s all you need to do. The next day set the timer for 3 minutes and do your physical activity until the timer rings. Then, increase it to 5 minutes, and so on, gradually building up to 20 or 30 minutes.

3. Vary the input: Sometimes it helps to give the nervous system a new set of inputs. Through gentle manual therapy, it is possible to coax the system into lowering its guard against movement and speed up the tolerance to physical activity. So, seek out a healthcare professional, who specializes in manual therapy and jump-start your journey back to a more active and less painful life.


Image courtesy of Salvatore Vuono at FreeDigitalPhotos.net

0 Comments

The effect of words on pain experience and movement

9/22/2015

0 Comments

 
Thanks to advances made in the field of magnetic resonance imaging (MRI), it is now possible to visualize brain activity as it actually takes place. This type of imaging detects changes in the level of oxygen and blood flow during neural activity. When an area in the brain is active, it needs more oxygen, which means blood flow to that area increases. On the scan, these areas will appear to “light up”. With the advent of the functional MRI (fMRI) it has become possible to investigate and map which areas in our brains are responsible for the different neural processes required to keep us moving, thinking and feeling. Researchers interested in studying pain have, of course, also availed themselves of this technology.

One important discovery in the last few years has been the connection between what we think and feel about pain with the actual experience of pain. Turns out that how a physical problem is explained to us – that is, the choice of words that are used – can actually increase or decrease how much pain we perceive. Our willingness or fear to move seems to be directly related to this perception.   

The following single case study* using fMRI demonstrates the effect a session of therapeutic neuroscience education (TNE) had on a patient who was scheduled to have surgery for a lumbar disc herniation. TNE seeks to increase the patient’s knowledge and understanding of pain and to reduce the fear associated with injury and movement. The intricate concepts about what pain is and how it works are explained with metaphors and pictures that the patients can easily understand.

The images below** are of the fMRI scan of a patient facing surgery for a herniated disc in the low back. Preoperatively, this person received a session of TNE. The top row of images show the patient at rest. The middle row shows the patient performing a painful spine movement prior to TNE. The bottom row of images show the patient performing the same movement after TNE.
 


Pain

Pain is the result (output) of an interpretation (neural processes) that the brain makes in response to threat messages it receives (input). This does not mean that pain is imagined. It is a real and very individualized neural event as the fMRI demonstrates. It is, however, influenced by various outside sources. The words that are used to explain the reason for pain are one of those sources.***

Footnotes:
* Preoperative Neuroscience Education: Single fMRI case, submitted for Publication Louw, Diener, Peoples and Puentedura, 2014
** Permission to use these images was obtained from Adriaan Louw, PhD, PT, CSMT
*** It should be noted that a single case study cannot prove cause and effect. Randomized controlled trials (RCT) with larger numbers of individuals included in the trial are the rigorous studies one seeks. At least one such study was published by the same authors last year: Louw A, Diener I, Landers MR, Puentedura EJ. Preoperative Pain Neuroscience Education for Lumbar Radiculopathy: A Multi-Center Randomized Controlled Trial With One-Year Follow-Up. Spine. May 28 2014.


0 Comments

Did you know that September is National Pain Awareness Month?

9/2/2015

0 Comments

 
As we talked about in the last post, learning about pain is an important part of fighting it. The more we know about what it is we’re trying to manage and/or get rid of, the more successful we will be.

Chronic pain affects more people in America than diabetes, cancer and heart disease combined. Based on the latest calculations, 100 million Americans are in pain daily. That is about 1 of every 3-4 people! This translates into an estimated annual cost of more than $630 billion spent on medical care and lost productivity. And what about the personal costs – loss of function and quality of life? *

In its 2011 report, the Institute of Medicine emphasized the need for better understanding, assessment and management of pain, with an eye on prevention of chronicity and on promotion of patient self-management of pain. The call went out to train not only healthcare providers more thoroughly in the complex biological and psychosocial aspects of pain, but also to educate the public at large, and especially the patients.*

We already established that good science supports getting the brain involved in this battle against pain. (See the previous post here: http://www.vtsphysicaltherapy.com/did-you-know-blog/your-brain-is-ready-to-fight-pain). Throughout this month, I will post information to help you feel more empowered in your pursuit of a life that is not hampered by it. 


So, let’s get started with this 5-minute video produced by some kindred spirits from Down Under.


What is one thing you can try this week to help you begin your journey toward a healthier you? I would love to read your comments below. Do you have any questions you would like to address to me privately? Click here (http://www.vtsphysicaltherapy.com/contact.html) to send a private message. 

* Available at: http://www.iom.edu/~/media/Files/Report Files/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research/Pain Research 2011 Report Brief.
0 Comments

    Author

    Victoria T. Strickland, Doctor of Physical Therapy / Owner at VTS Physical Therapy

    Archives

    March 2016
    January 2016
    September 2015
    August 2015
    July 2015

    Categories

    All

    RSS Feed

Picture
Picture