Pain Management

Types of back and neck pain

7 Types Of Pain In The Back and Neck

Pain and Physical Therapy

Physical Therapy is considered one of the best ways to treat multiple types of pain because it focuses so much on treating the root cause and not just the symptoms. Combining hands-on treatments like orthopedic manual therapy with proven pain management techniques like dry needling while progressing through therapeutic exercises brings patients better long-term relief.

The International Association for the Study of Pain (IASP) describes pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described  in terms of such damage.” When we are presented with something that causes pain, if capable, we rapidly or reflexively pull out. The tactile sensation of pain is called nociception.  

Pain is an awkward inclination that lets you know something might be wrong. It may be consistent, pounding, wounding, throbbing, squeezing, or depicted in many other ways. Now and again, it’s simply an annoyance, like a migraine. At different times it tends to be debilitating  

According to John Hopkins, medical pain can bring about other physical symptoms, like nausea,  dizziness, weakness, or drowsiness. It can generate emotional consequences like anger,  depression, mood swings, or irritability. In certain cases, pain could completely change your way of life and affect your job, relationships and independence. 

There are two categories to classifying pain 

  1. Acute Pain 
  2. Chronic Pain  

Types Of Pain

Acute Pain

It usually happens rapidly and disappears. Acute pain generally comes on abruptly and is brought about by something explicit. It is sharp in quality. For the most part, intense agony doesn’t endure longer than a half year. It disappears when there could be, at this point, not a basic reason for the aggravation. Acute pain ordinarily begins unexpectedly after a physical injury, a cut, wound, or muscle injury. Acute pain can likewise be brought about by fever, inflammation, and menstrual cramps. Acute pain is regularly treated by educating the patient, medication, exercise-based recuperation/physical therapy, chiropractic massage, or dynamic development programs.  

Chronic Pain

Chronic pain is continuous and, as a rule, endures longer than a half year. This pain can continue even after the injury or disease that caused it has recuperated or disappeared.  Certain individuals experience chronic pain in any event when there is no previous injury or issues. According to Cleveland Clinic, Chronic pain is linked to conditions that include:  

  • Headache
  • Arthritis
  • Cancer
  • Back pain 

Chronic pain is normal; it influences 1 of every 5 grown-ups and is the number one cause of disability globally. Chronic Pain is a quiet pestilence that diminishes personal satisfaction, adversely impacts connections and occupations, and causes depression. (Sessle, 2012).  

Types of Back Pain

According to the Health Policy institute, back issues are patients’ most regular complaints to their primary care physicians. Almost 65 million Americans report a new episode of back pain. Approximately 16 million grown-ups – 8% of all grown-ups – experience industrious or constant back pain, which has restricted them from carrying out certain activities in their everyday life.  Back pain is the 6th most exorbitant condition in the United States.  

There are three types of back pain; Axial Pain, Referred Pain, and Radicular Pain. 

Axial Pain:

Also known as mechanical pain. Axial pain is usually restricted to one specific spot or region in the lower back area. Axial pain is patients’ most common type of lower back pain. 

Axial Back Pain

Referred pain

This is a type of pain that is not restricted to one specific region it tends to move around, and the intensity of the pain often varies. Referred pain is the type of pain that a patient faces in one part of the body which is influenced by an injury or discomfort in another part of the body.  

Radicular Pain

According to spine health, radicular pain can be described as electric shock-like or burning; radicular pain follows the way of the spinal nerve as it leaves the spinal canal. This sort of aggravation is brought about by pressure as well as irritation to a spinal nerve root. In the lower back (lumbar spine), radicular pain might go into the leg. Different expressions for radicular pain are sciatica or radiculopathy (when joined by shortcoming or potentially deadness). It very well may be brought about by conditions, for example, a herniated plate,  spinal stenosis, or spondylolisthesis.

Sciatica Back Pain

Click here to read more about Sciatica

 

Types of Neck Pain

Neck pain is torment in or around the spine underneath your head, known as the cervical spine.  Neck pain is a typical side effect of previous injuries. According to the Cleveland Clinic, Neck pain is extremely normal. It happens in around one out of three individuals no less than one time each year. It is more normal in ladies than in men, and the possibility of developing neck pain increases with age.  

According to UpToDate Patient education: Neck pain (Beyond the Basics), The most common  causes of neck pain are Cervical strain, Cervical spondylosis, Cervical discogenic pain, Cervical  facet syndrome,  

Cervical Strain

A cervical strain is one of the most common issues that is being faced today. This usually occurs the neck muscles suffer an unusual injury. Cervical strains are usually caused due to sports-related injuries with heavy impact and physical/mental stress in everyday life, including poor nutrition and poor posture. Cervical strains last up to 4-6 weeks; neck muscles’ most common cervical strain symptoms are stiffness and tightness.  

Cervical Spondylosis

Cervical Spondylosis is a condition brought about by unusual cervical spine tears (degenerative changes). The most common symptoms of cervical spondylosis are neck pain, headaches, numbness, and little to no neck mobility. 

Cervical Neck Pain

Cervical Discogenic Pain

This type of neck pain might be the most widely recognized reason for neck pain. It is brought about by degenerative changes in the structure of at least one of the discs in the middle of the cervical vertebrae. The most common symptoms are pain in the neck while turning or shifting your head.  

Cervical Facet Syndrome

The facet joints are situated on the sides of the vertebrae, and arthritis in this space can cause pain in the center or side of the neck; certain individuals additionally notice pain in the shoulders, around the shoulder blades, at the foundation of the head, into the ear and jaw, or in one arm. A typical reason for cervical facet syndrome incorporates a task requiring an individual to expand the neck repeatedly in their daily life. 

Diagnose and Treating Your Pain

There are endless possibilities to modify a physical therapy treatment program in order to relieve your specific back or neck pain. At Balanced Physical Therapy, our Doctors are licensed and certified to diagnose the exact cause of your pain symptoms. We take a unique 1-on-1 approach to each treatment session to ensure that all our patients receive our undivided attention and are properly progressing throughout all phases of the rehabilitation. Visit our contact page to schedule an evaluation or to find out more about our doctors, treatments, and network of insurances.

Instrument-Assisted Soft Tissue Mobilization

IASTM: Manual Therapy For Movement Restrictions, Tension, and Pain

What is IASTM in Physical Therapy?

Instrument-Assisted Soft Tissue Mobilization (IASTM) is a type of manual massage therapy used by physical therapists. Commonly known as the Graston Technique, this type of treatment can be beneficial for many people with movement restrictions, tension, and pain.

The Taylor and Francis journal defines IASTM as “a skilled intervention that includes using specialized tools to manipulate the skin, myofascia, muscles, and tendons by using various direct compressive stroke techniques.”

Tightness, tension, and pain while sitting at office

What does IASTM Do?

Instrument-Assisted Soft Tissue Mobilization helps break down restrictions, reduce pain, and facilitate healing by addressing musculoskeletal problems at the cellular level.

At the musculoskeletal level, a facial restriction is often a combination of scar tissue and adhesions built up over time. Ortho Bethesda does a great job explaining that “Scar tissue and adhesions essentially act like superglue in your body. When scar tissue is created after injury, new cells are laid down excessively and in a disorganized manner. Scar tissue/ adhesions prevent the muscle or other tissues from lengthening appropriately.” 

IASTM is a way for physical therapists to use controlled microtrauma to stimulate a natural inflammatory response. When your body produces an inflammatory response, it triggers a series of events that include reabsorption of excess scar tissue and fibrosis that is causing restriction.

Additionally, IASTM also triggers a vascular response resulting in increased blood flow and improved healing. There is even a neural effect throughout pain receptors along the skin responsible for managing pain.

Who can benefit from IASTM?

IASTM treatment can be beneficial for a variety of impairments and conditions. It can be beneficial for many people undergoing orthopedic surgery, people that sit for long hours in an office, and athletes after intense training or injuries. Your physical therapist may provide you this manual therapy for impairments such as:

  • Limited mobility
  • Pain with motion
  • Loss of range of motion
  • Decreased muscle recruitments
  • Excessive scar tissue formation 

More specific conditions that benefit from the application of IASTM include:

  • Plantar Fasciitis
  • Carpal Tunnel Syndrome
  • Neck Pain
  • IT Band Syndrome
  • Heel Pain/ Achilles Tendinitis
  • Ankle Sprains and Strains
  • Back Pain
  • Shin Splints
  • Post Surgical Hip and Knee Replacements
  • Musculoskeletal Imbalances
  • Rotator Cuff Tendinitis
  • Myofascial Pain and Restrictions

Physical Therapy for Neck Pain

For certain conditions, instrument-assisted soft tissue mobilization may not be recommended. These can include having:

  • Unhealed Fracture
  • Hematoma
  • Hemophilia
  • Uncontrolled Hypertension
  • Open Wound
  • Patient Hypersensitivity 

What to expect during and after an IASTM Treatment

IASTM treatments during physical therapy sessions are often paired with a warm-up such as heat, stationary bike, elliptical machine, or light jogging to make the tissue more pliable. After a warm-up, your therapist can begin working with stainless steel, plastic, or titanium instruments that contour to your body in order to find the specific tissue and muscles that are restricted.

Tools used by Physical Therapist for IASTM

Instrument-Assisted Soft Tissue Mobilization starts with gentle pressure and steadily increases in order to effectively treat the areas causing pain and movement restrictions. At Balanced Physical Therapy, we encourage open communication and let our therapists know when the pressure becomes too uncomfortable to tolerate.

After the IASTM treatment, most patients follow up with more exercise to help restore better movement patterns. Some soreness after treatments is considered normal; patients should not panic because it does go away and gets less severe with multiple treatments. If you are attending physical therapy anywhere from 2-3 times per week, a noticeable result can be felt by the 3rd or 4th appointment (sometimes even on the first treatment). When IASTM is combined with exercise, stretching, and a focused effort on home exercises, patients can progress reasonably quickly through their recovery.

If you would like to learn more about IASTM or are experiencing pain, tension and movement restrictions give us a call to speak with a therapist. Our team is always ready to help you make the best decision with regard to your overall health and wellness.

Dry Needling Treatments

Dry Needling: Therapy for Pain and Movement Impairments

Balanced PT offers dry needling treatment to help with neuromusculoskeletal pain and movement impairment. Learn more about the dry needling process and some specific conditions that benefit from this treatment.

What is Dry Needling?

Dry needling is a safe and minimally invasive treatment used to help patients with neuromusculoskeletal pain and movement impairments(Mayo Clinic). Some benefits include decreased muscular pain, easing trigger points, and improved range of motion.

It is administered by certified and trained healthcare professionals such as physical therapists, medical doctors, and some chiropractors. Some other common names for dry needling therapy include trigger point dry needling (TDN) and Functional Dry Needling (FDN).

Difference Between Dry Needling and Acupuncture?

While dry needling stems from traditional Chinese medicine like acupuncture, dry needling is a treatment that has evolved into a modern western medicine treatment. Inserting needles into the skin is something both dry needling therapy and acupuncture share, but after that, the treatments are undoubtedly different (Denver Physical Medicine and Rehab).

Acupuncture treatments are more of traditional eastern medicine based on restoring the proper energy flow throughout the body by inserting needles along meridian lines. 

Dry needling therapy has been developing since the 1980s and focuses on relieving chronic and acute pain by inserting needles into trigger points to restore normal function.

Will Dry Needling Therapy Work For Me?

Patients that are experiencing chronic pain are typically great candidates to receive dry needling therapy. Patients can expect to see the most significant benefits when this dry needling is incorporated with exercise, manual therapy, stretching, and education. It is a low cost, low-risk treatment that can help with conditions such as (Virginia Sports Medicine Institute):

  • Acute and Chronic Tendonitis/ Tendinosis
  • Athletic Overuse Injuries
  • Carpal Tunnel Syndrome
  • Frozen Shoulder
  • Muscle Spasms
  • Whiplash from auto accidents
  • Ehlers Danlos Syndrome
  • Fibromyalgia
  • IT Band Syndrome
  • Sciatic pain
  • Tennis and Golfer’s Elbow
  • Neck and lower back pain

Whiplash from auto accident

While dry needling can be beneficial to various conditions, it is also essential to know when dry needling is not appropriate. Dry needling is not suitable and potentially harmful (Cleveland Clinic) for the following reasons:

  • A patient with a needle phobia
  • Pregnancy (first trimester)
  • Patient with an allergy to metals
  • Patients that have an infection present
  • Needling over cosmetic implants
  • Patients with a heart valve replacement (endocarditis)
  • Patients with epilepsy (or other seizure disorders)

Suppose you are looking for natural pain management treatment options, and dry needling is not an option. In that case, we always recommend scheduling an appointment with your primary care physician, orthopedic surgeon, or physical therapist. They will be able to diagnose your pain and provide you with a list of safe treatments available near you.

How Does Dry Needling Work?

Multiple clinical studies show that dry needling works by restoring muscles to a normal resting state. We know that patients suffering from chronic pain, a traumatic injury, or overused muscles often develop trigger points (also known as knots) that cause pain and discomfort. 

Looking further into why this causes you pain, research shows that the trigger points form due to prolonged or abnormal muscle contraction where your muscle is not receiving enough blood supply. The lack of blood supply (filled with oxygen and nutrients required for healing) to an injured area will cause the surrounding tissue and nerves to become more sensitive.

By stimulating the trigger point with a sterile needle, dry needling therapy can help drive more blood to an injured area, release muscular tension, and help the brain release endorphins that promote healing.

Step By Step Dry Needling Procedure

Before administering dry needling therapy to any patient, your physical therapist will perform an examination that includes your past medical history to ensure the treatment is appropriate and safe. Part of the evaluation will also consist of your therapist using palpation skills to identify trigger points causing pain and limited motion.

Phsyical Therapist finding trigger points for dry needling treatmetn

Once you and your therapist agree that dry needling will benefit your recovery, the therapist will go over each part of the treatment in more detail (Verywell Health). Specific details that help patients understand dry needling can include:

  • How long does dry needling take? Typically a single treatment can take anywhere from 15-30 minutes, which is most commonly a part of a total of 30-60 physical therapy sessions.
  • What to wear for a dry needling appointment: We recommend our patients wear the usual, comfortable physical therapy attire. Clothing that allows easy access for your therapist to administer the treatment is always a good idea. 
  • Insurance information and expected costs: Some insurances do cover dry needling, while others do not. It helps to know upfront what co-pay and out-of-pocket costs to expect.

Once an evaluation is complete, some patients can start dry needling therapy that same day( others may need to wait until the second appointment, this varies from clinician to clinician.)

Your physical therapist will always begin the dry needling procedure by sterilizing the treatment area and preparing the needles in a private setting. After preparing the treatment area, the therapist will start inserting thin, dry needles (needles that do not contain medications or fluids ) into problem-causing trigger points. 

The dry needles are inserted directly into the skin at varying depths (depending on the dry needling technique). Oftentimes, patients will feel the physical therapist gently move the needle around to stimulate a local twitch response. A local twitch is a good thing, as it signifies that a muscle is reacting to the treatment.

After 15-30 minutes, your therapist will carefully remove the dry needles. They will inspect the treatment area for bleeding and skin reactions before leaving for home.

What To Expect After a Dry Needling Treatment

After a dry needling treatment session, patients often report a decrease in pain and an increase in range of motion. In more severe cases, a patient will require more than one treatment to reach the desired results.

Muscle soreness and light bruising is a common side effect of dry needling, for which your therapist may recommend rest, heat, or ice. These symptoms typically resolve themselves over a couple of days to a week.

If you are experiencing more severe side effects (these are considered rare), such as difficulty breathing or significant bleeding, we recommend contacting emergency medical services immediately.

Schedule Dry Needling Treatment Today

Balanced Physical Therapy offers safe, effective, and certified dry needling treatments. Our patients enjoy working in one-on-one therapy settings with board-certified physical therapists. To schedule an appointment, call us at (586) 741-5806 or visit our Appointments page to schedule an evaluation.

 

 

 

Preventing Overtraining Syndrome

Prevent Overtraining Syndrome and Overuse Injuries in Youth Sports

Helping parents, coaches, and young athletes understand overtraining syndrome (OTS), the specific injuries associated with overuse, early signs of detection, and general guidelines for training.

Overtraining in Youth Sports

With over 30 million youth sports participants ages 6 to 18, it is important for parents and coaches to know about overtraining syndrome (OTS), the specific injuries associated with overuse, early signs of detection, and general guidelines for training.

Every year more children and adolescents are participating in organized and recreational sports. This is a great sign in the fight against childhood obesity as it builds lifelong physical activity habits, promotes healthy competition, and builds skills for future opportunities. Unfortunately one of the downsides with increased activity in youth sports is the increased risk of overtraining, overuse injuries, and burnout.

What is Overtraining Syndrome (OTS)?

Overtraining Syndrome (OTS) is more commonly referred to as “burnout”. OTS or “burnout” is caused by intensely working the body for long amounts of time without allowing the time for rest and recovery.

The American Academy of Pediatrics describes overtraining syndromes as a “series of psychological, physiologic, and hormonal changes that result in a decreased athletic performance. With so many options such as football, gymnastics, swimming, wrestling, and tennis at all levels; kids have naturally become more likely to suffer from injury.

What is an Overuse Injury?

Overtraining can directly cause an overuse injury. Overuse injuries often include damage to bone, muscle, and tendons. These injuries can be classified into 4 stages:

  1. Pain in the affected area after physical activity
  2. Pain during physical activity, but not restricting performance
  3. Pain during physical activity that also restricts performance
  4. Chronic, persistent pain, even at rest

Because young athletes’ bodies are still developing, they are more susceptible to overuse injuries. Their bones are still growing, therefore cannot handle as much stress as fully developed adults. Generally, the best way to prevent major overuse injuries is to understand and identify the young athlete who is at most at risk.

If your young athlete is showing signs of injury, it is always a good idea to get a professional assessment. A physical therapist can diagnose the injury and provide a treatment plan to safely return to competition.  Contact Balanced Physical Therapy to schedule a free injury screening or comprehensive evaluations here.

Common Overuse Injuries in Youth Sports

Some examples of overuse injuries and risks that may result from overtraining in youth sports include:

Little league and travel baseball players can be at risk for throwing injuries such as medial apophysitis or “little leaguer’s elbow”. Too much overhand throwing, especially with poor technique, can result in excess inflammation and irritation in the elbow. This can have long-lasting effects on the medial apophysis growth plate.

A child or adolescent gymnast can be at risk for developing spondylosis (pain in the spine due to deterioration) when doing repetitive hyperextension and rotation while participating.

Preventing Overtraining in Youth Athletes

Young swimmers are susceptible to shoulder injuries such a rotator cuff or bicep tendonitis, shoulder impingement, and neck pains.

Track and distance runners often develop shin splints and stress fractures as a result of overtraining.

These injuries are commonly caused over time, and not suddenly. This is good news, especially for parents and coaches who know the signs of overtraining and overuse.

Signs of Overtraining and Burnout

Parents and coaches concerned about the possibility of overtraining have multiple ways to tell when a young athlete needs more time to rest and recover. The Boston Children’s Hospital lists common signs of overtraining that include:

  • Slower times in distance sports
  • A decrease in athletic performance
  • Decreased ability to achieve training goals
  • Decreased motivation to practice
  • Young athlete getting tired easily
  • Irritability and unwillingness to work with teammates
  • Disturbance in sleep schedule
  • Weight loss or appetite changes

How To Prevent Overtraining Syndrome

General guidelines suggest that to promote fun, develop skills, and achieve individual goals; a young athlete requires good training and rest balance. Some ways to prevent overuse injuries and burnout include:

  • Encourage young athletes to take 1-2 rest days per week. This allows time to recover physically and psychologically between competition.
  • Advise young athletes that their weekly training time, repetitions, or total distance should not increase more than 10% per week.
  • Encourage athletes to take a seasonal rest from a single sport for 2-3 months a year. Taking breaks and developing other skills are essential for preventing injuries.
  • Focus on proper nutrition, hydration, and sleep.
  • Be mindful and cautious when entering multiple tournaments on consecutive weeks
  • Be consistent with yearly checkups with pediatricians and family physicians. 
  • Emphasize that the reason we participate in sports is to have fun, develop healthy lifestyle habits, and improve athletic skills.

Using these guidelines, parents, coaches, and healthcare professionals can help keep young athletes injury-free. Mixing in rest days and diversifying the activities kids participate in can help tremendously when developing skills and avoiding burnout.