August 2020 Blog and Video
What Is The Best Way To Relieve Pain?
Is there a best kept secret to pain relief?
Yes!...and no. Let me explain. When you are in pain, you begin looking for solutions to relieve pain...make sense? The simplest solution for you is generally to take it easy with some heat or ice as you reach for some pain relievers like ibuprofen and acetaminophen. Maybe you're even hoping that your next massage will be able to help solve it. Your focus is on pain and making it go away. You feel tight so you stretch. You feel sore so you massage and rub the area. Maybe you've not been doing the same amount of exercise you used to so you blame your problems on being weak. You start working out again.
Let's say that you like to walk or run as a part of your exercise routine for a healthy mind and body. Once you are feeling better, you go back on a walk or run and the same knee pain happens again..."CRAP! Why does this keep happening? I thought I was doing better."
So here's the thing, we often won't pay attention to our problems until we have pain and we only have pain once our problems have reached beyond a certain threshold of irritation. When we rest and pain goes away, it doesn't mean that the problem goes away. This just means we took enough stress off of it for long enough so it stops complaining for the moment. Pain really isn't the problem, it just makes us more aware of the problem.
Once you find out what amount or types of activity activates your pain, you have a few options. 1) You can either push through the pain and use whatever you have found useful to help manage the pain, or 2) you can adjust your activity level so that you don't push yourself into pain, hoping that this will keep it from getting worse. This may even have you giving up something that you enjoyed doing because "I have a bad (fill in the blank)."
If NEITHER of these options sound good to you, I'll let you in on a little secret...option 3. Option 3 is to focus less on pain and less on what may or may not be "wrong/damaged/defective" with that body part. Option 3 is to focus on how to learn to move more efficiently so you can take stress off that area, allowing you to go back to doing what you enjoy.
There has been a lot of research to come out recently that shows that pain does not always correlate with damage, injury, or something being "wrong" with that body part. The assumption that "if your pain doesn't just get better over time with some rest, medication, stretching and strengthening, then something must be wrong with it" is nothing more than that...an assumption! This is an assumption that is not backed by scientific evidence and is based on a false belief that many people (including the health professionals) continue to perpetuate because they can't figure out what else to do about your problem. You might even be pushed towards surgery.
For the record, I'm not anti-surgery. Surgery can be really wonderful and necessary. I just want to make sure that we've addressed the movement problem that lead to the need to have surgery. And I want to try to address it before surgery to see if it is actually necessary.
In my opinion, most people who find themselves in a situation like this, have failed to recover because they have not gone about exploring the real reason for the problem in a very useful or meaningful way. There may or may not be some wear and tear on the joint or muscle that is in pain, but why is it there and not other places in your body?
Pain relief is not something I necessarily focus on as a physical therapist, but is often a result. I like to think of what I do in terms of actively listening to someones story to help them match up their history with how their body moves...or doesn't move.
As we go through a movement assessment, the person in front of me has the opportunity to explore their body with the intention of trying to learn more than was previously known about their whole body as it relates to what they are struggling with. This results in a better understanding of why they are feeling what they are feeling...understanding why that part of their body is under more stress than others.
The body is complex and it can be difficult to understand what is going on, but this is what I help my clients with...
"When you turn your shoulders left and right, do both directions feel the same? Is there pain? When you turn left, where to do feel stretch or pressure? Where do you feel it when you turn right? Does one feel more natural?"
We can then look to other movements and other places in the body to understand how one area is influencing the other. We inevitably find which areas of the body don't move well, even if they don't currently cause pain. One of the most useful pieces of information that we discover is often that they don't experience a stretch where they should or as they do on the other side of their body.
If you look up with your head and neck and you don't feel a stretch in the front or your neck, only pressure in the back, that isn't ideal. If you look down and you mostly feel a stretch at the base of your skull and then a gap before your feel it in-between your shoulder blades, that isn't ideal either. You should feel a nice comfortable stretch in the whole length of your neck. Not feeling a stretch in an area indicates stiffness, or no movement happening at those joints. It may not be painful, but we use our necks to do lots of things, including standing and walking. A neck that doesn't move well can cause show up in other places in the body and cause headaches, calf tightness, shoulder problems, and low back problems to name a few.
The point of explaining all of this is to make this point, which is also the secret...
Knowing where to treat is more important that the specific treatment, technique, device, or methodology you use to address it.
We often default to treating the area that is painful because it seems to make sense and it usually feels helpful. We also feel comfortable with the idea that having a strong core will prevent a lot of pain and injury problems so we can stay active for many years to come. I don't have a problem with either of these ideas, but would caution you. Even though it may have helped some people you know, these concepts are MASSIVE over-simplifications that are difficult to meaningfully apply to your specific problem without bringing further understanding to the table.
In order to learn more, we need to observe more. In order to observe well, that person needs to have a really good understanding of human movement and appreciate it's complexities.
If you tell someone that you have knee pain or foot pain and they immediately want to give you something to try without doing an assessment of your problem, it's probably not very good advice. It may end up helping, but at that point you are just playing the odds...without really even understanding if the odds are even in your favor.