Part 2 of 4: The Origins of Pain
Patient education is important in understanding the human body and what it’s trying to tell us. When it comes to functional issues, “pain” is a bit abstract. Pain could mean damage to the body, but not always. Pain could be felt disproportionally to the dysfunction, either hurting more or less than one would expect. Pain can radiate to other areas of the body, requiring an evaluation to find the origin of dysfunction. It’s not easy, the body is a kinetic chain stacked on itself, like a Jenga tower. From the balls of your feet to the top of your head, any number of movement or balance issues can cause the body to compensate. Ignoring these issues for too long will cause the tower to collapse. That’s why functional issues are the number one contributor to disability in the United States and the number one cause for workers’ compensation claims.
Painkillers become counterproductive in patients dealing with functional issues, especially chronic sufferers. Painkillers work by tricking the body into ignoring the pain rather than fixing it, leaving the nervous system hyper sensitive to stimuli when the painkillers wear off. As healthcare providers, it’s necessary for us to educate our patients and inform them of their options when they enter the healthcare system.
Musculoskeletal Disorders
The functional issues we are talking about are called Musculoskeletal Disorders (MSDs). It sounds scary, but it refers to any injury or disorder that affects the human body’s movement or musculoskeletal system. Muscles, tendons, nerves, bones, ligaments, connective tissue, and cartilage all make up the musculoskeletal system and contribute to the body’s movement, form, and stability.
Painkillers are most frequently prescribed for treating MSDs or for pain relief after surgery. Receiving painkillers after surgery is common and is usually well managed by the surgeon, but still carries the risk of addiction. However, painkillers prescribed as a result of MSDs aren’t often necessary and might be doing more harm than good.
MSDs can be the result of acute injuries or chronic issues that have not been properly identified, addressed and treated. This biomechanical imbalance can cause the body to wear unevenly resulting in pain after either moving in a certain way or participating in a repetitive activity for too long. Acute pain is the result of a sudden and traumatic injury, such as a broken bone, a sprained joint, or a surgery. Chronic pain is ongoing or a buildup of pain from one or more movement dysfunctions that wear on the body over time.
Acute and chronic pain aren’t mutually exclusive, chronic pain can lead to an acute breakdown if left untreated. Acute pain can become chronic if it doesn’t receive proper rehabilitation. For both acute and chronic pain, there needs to be a plan of action that appropriately addresses the dynamic balance and functional health of the body. This is where movement specialists like physical therapists and occupational therapists come in.
Entering the Healthcare System
MSDs are, first and foremost, functional issues. MSDs are not medical. However, most people will likely enter the medical system through avenues such as an urgent care, emergency room, and/or a specialist. All of which come at great expense to the patient, including time, financial burden and delays in proper treatment. Unfortunately, it is difficult for medical doctors to identify functional issues. Seeing a physician first can lead to a few outcomes: a referral to a physical therapist or occupational therapist, a referral for imaging, or a prescription for painkillers with follow up appointments to track progression.
A referral for imaging isn’t a bad place to start and can provide a more thorough look at the issue. But, when it comes to your time and money, imaging is often an unnecessary step. While a medical doctor would almost certainly need an MRI or other imaging to help diagnose a dysfunction, a physical therapist or occupational therapist is trained to spot functional problems by evaluating a patient’s movement and kinetic chain. While a therapist might want imaging to confirm the findings of their evaluation or see the extent of damage, often times imaging is not necessary. Fortunately, Direct Access was created to make the process of getting help more streamlined.
It is now possible to see a physical therapist or occupational therapist, without a referral, to evaluate pain and functional problems immediately. Thus, skipping several steps in the process. Physical therapists and occupational therapists have the ability to help patients utilize the tools they already have to fight pain caused by musculoskeletal disorders and even prevent MSDs from occurring in the first place.
Know Your Right to Choose
According to the CDC, 1 in 6 people are predisposed to becoming addicted to painkillers. Of all the ways you can enter the healthcare system with MSD dysfunction, a wait and see approach, masked by painkillers is probably the worst. It may be easy, but it does nothing to improve the health or quality of life for a patient. The risk is also a lifetime of addiction to painkillers.
Simply reducing activity, or masking the issue rather than fixing it, is nearsighted and only allows the issue to compound. Painkiller dependency is a very real trap that many people fall into every year. To avoid falling into a cycle of addiction: do your research, seek a second opinion, and remember to advocate for a plan of care that is right for you.
Learn more about Work Injury Rehabilitation at Spooner. Ready to schedule an appointment? Schedule an appointment or complimentary movement screen with a Spooner physical therapist at one of our locations throughout the valley.