Early Treatment of Musculo-Skeletal Pain

So we have all done it. We feel a pain in a muscle or a joint and we hope it goes away, but then it doesn’t. It keeps coming back and gets worse. It might be a pain or discomfort in the background that doesn’t bother us much but then it can amplify when we are stressed or sick. For example, I have an area of vulnerability in my neck that can magnify if I am working at the computer a lot and looking down at the keyboard. I remember when I was studying for exams, the same pain in my neck just flared up completely. I was forced into treatment so I could sleep properly and get through the exams. I would not have needed as much treatment if I had gone when it was a minor pain.

Most new acute pain starts in the tissue affected. It could be the muscle or joint or in the case of the spine the disc. When there is inflammation in the area, the nerve tissue can also become hyper-sensitized and another source of pain. You don’t want a situation where an acute pain turns into something chronic lasting more than 3 months. When the nervous system is being irritated for a prolonged period the risk of the pain becoming amplified increases. This is through a process of central sensitization which involves the nervous system ‘off switches’ not functioning properly. In simple terms this just means that the threshold where the initial local pain is triggered is lowered so that the area becomes more sensitive. The normal inhibition of the nervous system is not functioning properly. This is why it is important to get the recent injury treated and not letting it linger. Not every new acute pain will turn into something more chronic, but we do know that certain injuries like whiplash can if they are not treated in the early stages.

A good example is lower back pain, coming from a bulging disc. This could then turn into a disc protrusion or herniation and then a bigger issue because of the sciatica that usually follows. A good physiotherapist can determine using bed-side tests which structures are likely affected and whether it is a disc-related injury. A disc bulge can be treated quite effectively with some manual therapy and certain exercises aimed at decompression and stabilizing the disc. By addressing it early on, you will avoid the more painful scenario of a disc protrusion or herniation.

If you find yourself with pain in the muscles or joints, you are better served by a physiotherapist that can offer a combined approach. Most injuries will require treatment of pain, inflammation and then later the underlying cause. Pain management (non-medicinal) can include acupuncture, manual therapy and massage, and use of heat and cold. Some electric-modalities like TENS can also be helpful. Education is also key. In the bulging disc example, simply guiding the patient on keeping their spine in the correct curve may alleviate their pain. By changing the position of the spine the painful tissues are off-loaded and can then start to heal.

So the take home message is, don’t let pain continue for long without getting treatment. Pain is your body telling you to take care of it. Our bodies give us valuable feedback and we can respond by taking care of ourselves.

If you have any questions about musculoskeletal conditions and pain, you can email Damian Wyard MSc PT (Physiotherapist) at: info@pilates4physio.ca

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