pain management

Chronic / Persistent Pain

Chronic / Persistent Pain

Chronic / Persistent Pain 1000 700 Ace Health Centre

Chronic/Persistent Pain

What is chronic/persistent pain?

Why is it that some pains last much longer than we expect them to? And why is it that if we have had a similar pain in the past which went away quickly is sticking around longer this time around? If we use the example of a muscle strain which we typically see muscle strains recovering in as little as 4-6 weeks, but when it lasts for 3-6 months why does it still hurt? Or why is it that when talking to two different people about their knee osteoarthritis, one has pain and limited with their activities while the other is reporting no pain and has no limitations?

Why is my pain lasting so long?

The short answer is there are numerous factors playing a role into how we experience pain and how long it can last. The longer answer is that our body/brain are very smart and very protective to keep us functioning. The brain and body use a lot of pathways to communicate to decide on the appropriate response to a stimulus (injury or event). The brain doesn’t want to waste time processing everything that happens to us so it creates shortcuts and calls on old memories, or things we’ve seen, how people have reacted to similar situations, or our expectations, stress levels, mental health, and mood. With this being said the brain decides to react to the stimulus or decides its not important enough to react.

So what does this mean?

In a sense this means that an injury that has caused pain and has recovered, may continue to persist due to our experiences and an ongoing fear avoidance to prevent ongoing pain. As we continue to build into that fear avoidance the body becomes more sensitive to pain and more restricted leading to longer recovery times. This is not to say that you should push through pain either though as that can also increase the bodies sensitivity. Discussing with a physiotherapist can help you find the right track back to your usual activities with graded exposure.There are also a few interesting cases out there that will further show how interesting the body is in reacting to different stimuli.

https://www.psychologytoday.com/au/blog/pain-explained/201911/tale-two-nails

And if you prefer TED talks instead of reading you can google “why things hurt” with Lorimer Moseley

Or contact us today to see how our physios can help you with pain management. 

ACE dry needling treatment

Dry needling?! Don’t be scared.

Dry needling?! Don’t be scared. 1000 667 Ace Health Centre

Most people would run for the hills when they hear the word needle and even more so when those needles are about to enter their skin. Most experiences that require the use of tiny, sharp metal sticks are usually not pleasant ones. Unless we’re talking about dry needling at ACE Health Centre!

Dry needling, also known as myofascial trigger point treatment, is the next big thing, used around the world when it comes to pain management and pain reduction. If that sounds all a little too scientific for you then read on! Our head podiatrist, Mike Luker took the time to write down a few notes for our patients to explain what dry needling is and what it does for those who experience some form or arches and pains in their body.

What is it Dry needling?

Dry needling is the process of inserting a thin filament needle into the muscle trigger points, tendons, fascia, ligaments, etc. This helps in stimulating the healing process of the soft tissue. It, therefore, results in pain relief and a reduction in muscle tension.

Is it painful?

No, it isn’t painful. Yes, the needles are inserted in the skin, but the needles are so thin that it’s usually a pretty gentle and pleasant kind of treatment. Some people might feel a brief local twitch response or mild pain sensation such as tingling, cramping or cramping sensation but compare to those needles at the dentist or doctor, it’s a walk in the park.

Dry needling VS Acupuncture

Dry needling is often associated with acupuncture as both use the needles to speed up the healing process. However, it can be well differentiated from acupuncture based on objectives and the philosophy behind both. Unlike acupuncture, which uses the Chinese points of insertion, dry needling uses trigger points to decide points of insertion.

What are the benefits?

Dry needling is beneficial for relieving a variety of musculoskeletal problems including:

  • Acute injuries
  • Chronic injuries
  • Muscle spasms
  • Fibromyalgia
  • Plantar Fasciitis
  • Shin splints
  • Ball of foot pain
  • Calf pain
  • Tendinitis
  • Hip pain
  • Knee pain
  • Sciatica

Research has therefore shown that the use of needles can improve pain control, electrical and biochemical dysfunction of motor endplates and reducing muscle tension.

Consult a podiatrist at ACE Health Centre to discuss your condition and see if the treatment is for you.

Whiplash-Associated-Syndrome

Whiplash Associated Disorder: What a pain in the neck

Whiplash Associated Disorder: What a pain in the neck 1000 682 Ace Health Centre

About 7 and a half years ago I had a car crash. I pulled a U-turn outside my house in the quiet suburb of Figtree in Wollongong, NSW and was struck on the front drivers’ panel by a car that I guessed was doing about 90km/hr. Unfortunately, I was deemed at fault (the Police effectively said that they weren’t able to prove he was speeding because there were no skid marks – my argument was that he didn’t have time to brake because he was going so fast – but I digress). Fortunately, the other driver did swerve because otherwise, he would have T-boned me and chances are I wouldn’t be here writing this. For that, I consider myself incredibly lucky.

However, despite all the fortune, I do consider myself also slightly unluckier than some, and that is due to the daily pain and discomfort on the left side of my neck (Whiplash) that accompanies me everywhere I go. It is here right now as I write this (somewhat stronger now that I’m focusing on it).

Don’t get me wrong, I manage absolutely fine now, but I recall it being quite bad in the first few months. However, I did the right thing initially and booked in for a Physio consult.

 

I didn’t go back to see my Physio, and I didn’t do the exercises.

I saw a local physio about a week after the accident whom I believe – knowing what I know now – actually let me down, and he let the physiotherapy profession down.

From memory he did some massage, might have put a heat pack on and then prescribed me a weird neck exercise on all 4’s (speaking as an undergraduate exercise science student at the time) and told me to “see how I go” and call if I wasn’t getting better.

I wondered if he actually did want to see me again? Did he care if I was doing better? Maybe he was thinking of my back pocket being a student – but I certainly wasn’t.

I just wanted my neck to feel better. I didn’t go back…

 

 

Without a proper diagnosis – I felt confused

I was a young, fit, virile male who just turned 20 and I did not want to do some strange looking exercise that didn’t even bring on a sweat. All I wanted was to push and pull and throw and lift and sweat!

I grew up playing sports and running. I feared that I wouldn’t get back to those things. Mentally at the time, my ego-driven immortality shroud (seen predominantly in males under the age of 25 due to a still-developing pre-frontal cortex) had been shattered.

Also, mentally, I was having nightmares and was anxious about driving. two major things we did not talk about in my physio consult.

I guess I existed in a state of confusion about my pain for about six months, until one day during a practical class in the final year of my Exercise Physiology degree at the University of Wollongong. We covered exercises for neck and shoulder dysfunction, and I was the example patient for my classmates.

I remember my fellow students prescribing me these basic, boring textbook exercises until our musculoskeletal lecturer Deidre McGhee (a practicing physiotherapist) stepped in to ask them to think about who they are working on.

In doing so she reminded me too. She gave me exactly what I needed at the time. Permission and empowerment. Two very major things in chronic pain.

Whiplash Associated Disorder (WAD)

I then took a particular interest in chronic pain when I went to study my Masters of Physiotherapy at Griffith University. Now into my 5th year of clinical practice, I have developed my clinical skills to a point where I can now focus on a particular area of interest. For me? You might have guessed – Whiplash Associated Disorder (WAD).

 

There are some pretty alarming statistics out there – here’s just a few:

  • Whiplash doesn’t tend to recover well – if there is still pain at 3 months after the accident, there is a 50% chance there will be ongoing pain 5 years later.

 

  • After an accident, if you can’t turn your head as far as you used to, or you find cold stimuli painful, your risk of long term disability is much higher. This risk remains high if you have severe pain, or are having trouble doing everyday tasks (reading, lifting, concentrating, working etc).

 

  • After an accident, if you can’t turn your head as far as you used to, or you find cold stimuli painful, your risk of long term disability is much higher. This risk remains high if you have severe pain, or are having trouble doing everyday tasks (reading, lifting, concentrating, working etc).

 

  • High levels of post-traumatic stress go hand in hand with poor recovery.

 

Whiplash recovery needs a systematic approach

If you have any of these things and you’re within the first month or two after your accident, the timing is crucial to reduce your risk of pain becoming chronic and disabling.

Either see a physiotherapist or talk to your GP about seeing a physio (and a psychologist if you’re having flashbacks or anxiety). CTP insurance covers nearly all cases of Whiplash recovery and treatment.

 

Though please, in a bid to avoid the situation I found myself in, see if you can find someone who has done some advanced training in Whiplash Associated Disorder within the last 2-3 years.

Learning from the physio I saw, in my professional life, I tend to listen to the person in front of me and ask many questions. It allows me to focus on the needs and goals of the person that is sitting in front of me and then applying the most recent evidence to assist them to achieve those goals.

For those that are past the initial few months since their accident, there is still hope of reducing your overall pain and disability. I have seen significant improvement in people using any necessary manual therapy, some tweaks to their daily life, and an increase in their exercise and activity safely under supervision.

It’s amazing the difference in your life when you find the person who knows exactly what you need at the time.