LEARN ABOUT YOUR PAIN, UNDERSTAND HOW YOU INJURED YOUR BODY, AND DISCOVER HOW OUR OFFICE CAN HELP.
There has been growing awareness in the medical community about the complexity of pain, particularly low back pain. It is increasingly recognized that disabling pain may involve factors beyond simple biomechanical or soft tissue issues. One factor gaining attention in the physical therapy field is the psychosocial, behavioral, and emotional components influencing pain. Chronic pain studies now focus on the neurological and physiological mechanisms of pain, exploring the connections between the immune, endocrine, and nervous systems. This approach also examines how the sensory cortex and brain become sensitized, along with the deregulation of the immune, endocrine, and nervous systems. By understanding how these systems function — and how they can malfunction — we can develop treatment plans that offer benefits beyond the traditional biomedical model.
We collaborate with the latest research from the Neuro Orthopedic Institute to understand the mechanisms of pain and how to overcome them. We recognize that all tissue can heal, and that the severity of pain doesn't always correlate with the extent of tissue damage. Our approach integrates graded motor activities with a deep understanding of the neuroscience of pain to help patients achieve pain-free function.
LEARN HOW OUR OFFICE CAN HELPYOUR INJURY:
By assessing patients from an anatomical and biomedical perspective, we can determine how pain affects their movement, activity, and overall well-being. It has been observed that similar diagnoses can lead to completely different outcomes: some individuals are severely disabled by pain, while others improve and move forward. Patients can also be evaluated from a cognitive-behavioral standpoint, using that information to develop a treatment plan that addresses the needs of those who feel entirely disabled by their pain.
The cognitive-behavioral analysis provides insight into problems and their consequences. We help patients identify beliefs and expectations associated with problem behaviors, fostering an understanding of these relationships. From there, we create a goal-oriented plan to help patients overcome their disabilities. These goals are broken down into manageable steps, helping patients gradually manage their overwhelming reactions to pain.
A recovery plan is implemented to engage patients in activities they previously avoided due to fear of pain or re-injury. We teach the skills needed for recovery, helping patients achieve independence, manage their limitations, and cope with potential relapses.
Dr. David Butler and Dr. Lorimer Moseley have extensively studied pain over the past 20 years. In their book Explain Pain, they offer valuable insights and strategies on the subject. Through their research, they have documented practical steps to help reduce patients’ pain responses and restore activity. They also founded the Neuro Orthopedic Institute, where they continue their research and publish regular updates in newsletters.
Restoring function and reducing pain requires both experience and effective communication. By applying a graded motor activity program, we can help patients regain activities of daily living (ADLs) and other life activities, including returning to work. This process is tailored to each patient’s tolerance but is progressive, offering the potential to restore a lost quality of life. I’ve observed individuals who, due to pain, become convinced they are disabled, often relying on diagnoses like spondylolisthesis or fibromyalgia. Many patients, for instance, believe their MRI results have permanently labeled them as disabled, leading to feelings of hopelessness and depression. However, the mind can be a powerful tool in the healing process. With resources like Explain Pain, which describes the biopsychosocial approach, I believe nearly all patients can overcome most of their disability.
The following are excerpts from the Explain Pain book
by David Butler and Lorimer Moseley:
“All pain experiences are normal response to what your brain thinks is a threat.”
“The amount of pain you experience does not necessarily relate to the amount of tissue damage.”
“The construction of the pain experience of the brain relies on many sensory cues.”
“Danger sensors are scattered all over the body.”
“If enough danger signals go through the spinal cord to the brain to the sensory cortex of the brain will conclude if you are in danger and need to take action it is the brain that activates several systems that work together to get you out of danger.”
“Tissue damage causes inflammation which activates danger sensors and makes the neurons more sensitive. Inflammation in the short-term promote healing and tissue healing depends are blood supply it all tissue can heal.”
“Pain persists the danger alarm system becomes more sensitive.”
“The danger messenger neurons become more excitable and manufacture more sensors for excitatory chemicals. The brain starts activating your neurons that release excitatory chemicals at the dorsal horn of the spinal cord. Response systems become more involved thoughts and beliefs become more involved and the brain starts adapting and becoming better at producing the neuro tag for pain. Your sensors in the tissue contribute less and less to the danger message arriving at the brain.”
“The management model shows focus not solely on the tissue we must also recognize the alarm system sensitivity fears, attitudes, and beliefs, and how each individual copes with their pain. Complete avoidance of pain or the opposite pain is undesirable and can contribute to going limitations.”
“Education and understanding are critical for you to overcome pain and return to life. Understanding that your hurts and pain won’t hurt me and that the nervous system is trying to protect you but is no longer able to inform you about danger. By being patient and persistent you could use graded motor activity to slowly restore ourselves to movement in life’s activities. We can seek out activities that produce danger reducing chemicals.”
“Research has shown that is best for your situation and planning your return to normal life with this graded motor activity and understanding the mechanism of the danger system and the function of the nerves in the brain.”