Tag Archives: Pain Management

Let’s Talk About the Complexity of Pain

What is Pain?

Pain is an unpleasant complex experience that occurs in response to a potential threat to our body’s tissues. No one really wants to have pain and if you do get pain you typically want to get rid of if ASAP. What we need to remember is that pain is normal and necessary to our survival as it is our body’s alarm system. The alarm system is there to help bring our attention to potential threats and to change our behaviour to avoid the threats if necessary. 

Everyone experiences pain differently. The way we experience pain depends on many factors such as the following: the severity of tissue injury, our emotional responses, previous experiences with pain, cultural experiences, the social and physical environment, our sensory inputs from receptors in our body, beliefs and knowledge about pain and our expectations about the consequences of pain.

For example: A person who is a major league soccer player that fractures their ankle will feel the pain very differently compared to a 65 year old person who is relatively sedentary because the soccer player may feel anxious about how is he going to make money if he can’t play soccer, whereas the 65 year old who generally is not very active will not have much change in their day. 

How Do We Experience Pain?  

When your body is injured in some way whether it be from stubbing your toe, repetitive use of you shoulder or appendicitis, the receptors and nerves in your body send this information to your brain and it is your brain that decides whether or not you feel pain. These receptors in your body are called nociceptors and they respond to thermal, chemical or mechanical changes on the tissues. For example, when you place your hand on a hot stove top the receptors in your fingers and hand sense that the temperature has changed. They then send messages to your brain about the temperature change and your brain decides if this change in temperature is a threat and if you should feel pain to make you take your hand away from the potential threat of a burn.

The signals from the nociceptors do not create pain. It is the brain decides that receives the signals from the nociceptors and other information such as your memories of pain, your beliefs about pain, your emotions at the time of the signal, your expectations and the information about the environment and uses all the information to decide whether or not there is a threat of damage and whether we should feel pain. The brain may decide that a nociception signal is not important and that we do not need to feel pain, so we ignore it. An example of this is when we are sitting in a chair the receptors in our bottom notice the change in pressure an send this signal to the brain. The brain then takes the information from the signal, and the environment and decides that sitting in the chair is not harmful so therefore we do not feel pain.

An analogy that can be helpful understand pain is to think of pain like a ship that is sailing in the ocean. The receptors are the lookouts on the ship, and they notice lights in the distance (these are the potential danger signals). The brain is the captain of the ship and makes all the decisions about how to sail.

The lookouts notice lights in the distance and tell the captain about them. The captain then considers his memories about these waters and takes in information about the environment. Maybe the captain knows these waters well and knows that these waters are safe and pirate free. He would then decide that the information was good to know but not very important, he may tell the crew members not to worry about it and they continue to sail as normal. This is like the when you sit in the chair and the brain decides that it is not a threat, so you continue sitting as normal without pain.

But if the captain is concerned by the information because he has never sailed these waters before and thinks that the lights may be pirates coming to rob the ship, he may tell the other crew members to stay on high alert. This is like when you place your hand on the hot burner and the brain creates a pain experience to make sure you are aware of the potential threat. He may even change the way he was sailing to avoid the pirates. This is like when pull your hand away from the burner because of the pain to avoid the threat of a burn.

Types of Pain

Pain can be either acute or chronic.

We tend to consider acute pain as pain that has a “mechanism of injury” such as a fall, motor vehicle accident, slamming your finger in a door etc. Acute pain typically is short lived, most times is not present past 3 months (BUT not always) and usually follows the stages of tissue healing (which are outlined in the picture below).

Chronic pain is when the pain is occurring for a longer period of time. It is often disproportionate to the stages of tissue healing and may or may not have a mechanism of injury that explains why the pain is there. Chronic pain can be very complex and is not fully understood. Chronic pain is usually pain that is present past the usual tissue healing process. Meaning that the tissues have likely healed, and no more damage is likely being done. But a reason we may still get pain is because our tissues have become more sensitized. If you think of the body as a ship again. Sometimes even through the ship has long since cleared the pirate-infested waters the captain and the crew remain hypervigilant to be sure they are safe. This means that now, even normal and helpful signals such as lighthouses, and ship horns may be perceived as threats. This can be the same as if we are in pain for a long time the entire system including the nociceptors and the brain become hypersensitive to all the information that even the normal signals that the brain usually ignores will be considered threats and you feel pain even though there is no tissue damage occurring.

Management of Pain

Management of pain can be complex because of all the factors that contribute to pain. Therefore, management of pain may have to be individualized. Pain management can include many things such as resting the area of injury, use of modalities such as ice or heat, education by a health professional about exercises, work or activity modifications, education about what to expect, healing duration as well as management strategies of stress or anxiety.

BodyTech Physiotherapy

Is Virtual Physiotherapy for you?

knee painBodyTech Physiotherapy is offering virtual physiotherapy appointments with our most experienced therapists. All you need is a phone, tablet or computer. It is as simple as clicking a secure link to connect with us in a video chat.

What to expect?

Your first appointment with us will be an assessment. The Registered Physiotherapist will ask questions to complete a history and gain a complete understanding of your injury in order to provide a diagnosis.

You will be asked to do a series of movements to allow the therapist to examine your range of motion and strength, as well as be able observe how you move and perform certain tasks. You may be asked to demonstrate walking, stairs, sitting, standing or any movement pattern specific to your injury.

Treatment

Based on the findings from your assessment, the therapist will be able to cue and correct your movement patterns. You will also be given specific exercises to help in your recovery. Your therapist may give you some self-directed treatment techniques, or teach another person how to assist you with these techniques.

You will have a chance to ask questions and clarify your abilities and restrictions. Your therapist will educate you about your condition and provide suggestions on how to modify your activities if needed.

Still not sure if virtual physio is right for you? Schedule a free 10 min phone consult with one of our therapists.

Call 519-954-6000 or email: info@bodytechphysio.ca

BodyTech Physiotherapy

The Importance of Posture

Posture types

Person A shows good posture, with a straight line going through the ear, tip of the shoulder, slightly behind the hip joint, slightly in front of the knee joint and slightly in front of the lateral malleolus (ankle) in the foot. The rest of the postures shown are incorrect, with different points of the body deviating either too far forward or too far behind the line that would indicate correct posture.

Posture is not typically on our minds until it starts to cause discomfort or injury. Today’s lifestyle regularly involves sitting or standing for prolonged periods of time, which is often sustained at the expense of proper posture. Posture refers to the position of our bodies, which is created by the different joint angles and the muscles that control those joints. Correct posture requires minimum muscular activity to maintain, which in turn minimizes stress placed on the joints. The opposite occurs with incorrect posture; muscles fatigue in attempt to maintain the altered position and joints are placed under increased stress.

There are a variety of factors that can cause or contribute to faulty posture. Correct posture may be difficult to maintain if joints are too stiff or too mobile, muscles are weak, too shortened or lengthened, or imbalanced. Over time incorrect posture will cause joint stiffness, thus causing the muscles to work harder and may result in pain. At this point, self-correction becomes difficult as it is harder to correct through joint stiffness. Joint stiffness will also result in some muscles becoming weak and others overused due to a change in the starting position of the stiff joint. Early identification of these contributing factors could prevent an injury from occurring, or from becoming a chronic problem that is more difficult to treat.

Possible consequences of poor posture include neck, shoulder, and back pain, or headaches and jaw pain from increased stress on muscles, joints, tendons and ligaments. Muscles will become shortened and tight from being in a slouched position, and the muscles on the other side of the joints will become lengthened and weak from constantly being stretched. The resulting muscle imbalance limits range of motion, changing the way the body moves, which will affect work or sport performance.

A detailed posture assessment by a physiotherapist can identify the contributing factors to poor posture, and is a smart idea for anyone wishing to be proactive and prevent future injury. Once these contributing factors are identified there a number of treatment options that will target the causes of the poor posture, prevent further injury, and help to decrease pain. A strengthening program will be designed to target weak muscles, and stretching will loosen tight muscles. This treatment combination works to correct these muscle imbalances, making correct posture easier to maintain while decreasing pain. Strengthening has the additional benefit of stabilizing loose joints, and joint mobilizations can correct stiff joints. Joint mobilization is a specific hands-on technique to improve joint movement, and can help to relieve pain and restore function. A combination of exercise, manual therapy and education will improve your course of recovery and assist with further injury prevention. Education about how to maintain correct posture in daily activities will allow you to remain pain free and prevent further injury.

Physiotherapy really does work!

BodyTech Physiotherapy

How many times have you heard friends or family say they had physiotherapy and it did not work for them? Or that they went to physiotherapy and all they got was a hot pack and a machine?

All physiotherapists and physiotherapy clinics are different. Just because you or someone you know had a bad experience at one clinic, does not mean you should not try another clinic. Why not check out BodyTech Physiotherapy? It was created out of a desire to  improve the quality of physiotherapy care in the city of Kitchener.

BodyTech Physiotherapy is an orthopaedic manual therapy and sports injury clinic. The clinic is owned and operated by highly qualified physiotherapists. We offer expert, hands-on care and individualized treatment for all conditions that cause pain or dysfunction.

What is orthopaedic physiotherapy/manual therapy?

Orthopaedic physiotherapy or manual therapy is physiotherapy that uses specific skilled, hands-on techniques administered by a physiotherapist to diagnose and treat soft tissue and joints. The physiotherapist uses their hands to mobilize (specific technique to improve movement) the joints to reduce stiffness, relieve pain, increase movement, improve muscle length and strength, and restore function. It combines an individualized exercise program with hands-on manual therapy to achieve pain-free function. Our physiotherapists at BodyTech Physiotherapy have undergone extensive, advanced-level post-graduate training to enhance their physiotherapy education, assessment and treatment skills. They have received their Advanced Diploma in Manual and Manipulative Therapy and have a combined 15 years of experience in a private practice clinical setting. Our assessments focus on identifying the underlying causes and contributing factors of your injury or condition. This comprehensive approach enables us to treat your condition or injury in the most effective way with an evidence based approach. A combination of exercise, manual therapy and education will improve your course of recovery and assist with further injury prevention.

Our approach to physiotherapy is individualized to focus on you – Physiotherapy really does work at BodyTech Physiotherapy!BodyTech Physiotherapy