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Managing Chronic Pain

Side view of a typical cervical vertebra

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Chronic pain is defined as pain that lasts longer than 6 weeks vs. acute pain which is something new and less than 6 weeks old.  Chronic pain can vary from one person to another as we all have different thresholds for pain.  Additionally we differ in the way we want to manage our pain.  Personally I hate pain, so if something happens to me that isn’t resolving in a few weeks I tend to seek treatment.  Other people may have a high threshold for pain, may have had a bad experience with medical treatment in the past, or just don’t know what type of care to seek, so they may do nothing for weeks, months, or even years.  Personally, I love a good challenge, so these are my favorite types of patients!!

The patients I treat with chronic pain seem to fall into a few diagnoses.  Migraine is the top on my list.  I have met many middle aged women who have had a lifelong history of migraine.  They have tried every type of treatment and every type of drug and pretty much have decided that this is just how it’s going to be.  I love treating these women and thankfully have been able to help most of them.  I typically start my assessment by evaluating the cervical spine and associated muscles.  Many headaches are caused by cervical tension and this is often a piece of the migraine picture.  I use CranioSacral Therapy to assess any restrictions within the bony structure of the skull.  Occasionally I will look at the entire spine and coccyx.  My favorite success still was 1 treatment to the coccyx in a mid 70s woman who had suffered a lifetime of migraine.  She continues to have headaches, but not migraine.

Chronic pain is also common in injuries of the spine.  Some patients have spine surgery and recover completely but for those who have problems with scar tissue, Physical Therapy that involves exercise alone may not be helpful for this group.  Often a short course of soft tissue and joint mobilization is all this patient may need to get them mobile enough to progress to exercise that is beneficial and not painful for them.  Some patients with spine pain also have muscle tightness in the pelvic cavity in a large muscle called the iliopsoas.  I have seen patients that have had prior treatment that failed to address this muscle tightness.  This muscle tightness is often easy to address but left untreated continues to be a source of pain referral to the low back.

Mary Boyd, MS, PT is the owner of Mountain View Physical Therapy and a member of the Sandpoint Wellness Council.  She can be reached for questions at 290-5575 or on the web at: www.MtnViewPT.com.

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