This is common with people who come into our office. To understand why drugs and injections did not last or work, first, you need to understand the mechanism of pain. We will be discussing how you feel pain and what questions you can ask youself to determine if drugs will help you or not.
What are the three mechanisms for feeling PAIN (nociceptor)?
1. Thermal- burns or sun burns
2. Chemical- (inflammatory response) irritation of free nerve endings in presence of chemical such as histamine, serotonin, H+ ions, substance P, and bradykinin. Bottom line: Chemicals treat chemicals (So drugs treat chemical problems)
3. Mechanical- deformation of collagen networks so that nerve endings are squeezed b/t collagen fibers. Can lead to damage tissue. Can be acute, subacute or chronic. But need a mechanist (physical therapist) to fix the problem. Drugs/ chemicals will not fix them. This can lead to problems in all body parts, which are fixable by a trained physical therapist.
How do I know that it is Chemical vs Mechanical?
Chemical pain is Constant pain, recent onset, swelling redness heat or tenderness, lasting aggravation, no movement can change the pain
You have constant pain (meaning your pain is every minute of the day)- chemicals treat chemicals and drugs will help.
You can have chemical and mechanical problems at the same time, but as time moves on the mechanical problem can stay if not fixed, once the chemical problem has been treated.
Mechanical pain can be constant pain or inter mitten pain.
Movements or changes in position can make your pain worse or better.
The Mechanics of your activities during the day can be a problem, even if you are not moving much.
The mechanics of how the musculoskeletal system is working together can be a problem
What questions can I ask myself to determine if I have mechanical pain or chemical pain to know if drugs or physical therapy is the direction I need to go for my problem?
Is your pain constant or intermittent?
If you have constant pain- it can be chemical or mechanical. Pretty much for most cases, if you have constant pain, DRUGS CAN HELP in these cases. You still may want to go to a good physical therapist to understand why you have this pain in the first place as most of the people who come to my office have no clue what they did to injure themselves.
If you have intermittent pain- (you have some time throughout the day without pain)- it is not a chemical related pain (as chemicals do not just come and go in the body) and drugs will not help much, you need to go to a GOOD PHYSICAL THERAPIST to fix your mechanics.
Are there any positions that make your pain better or worse?
If they can find positions that can alleviate some or all the pain, then you have mechanical pain. At the same time if you can move into positions that make your pain worse, it is also due to the mechanics. Go to a GOOD PHYSICAL THERAPIST to help you understand your injury to get you back to the activities you love.
Chemical pain cannot be changed by positioning-therefore DRUGS will NOT help.
When did your symptoms start?
This will helps to understand what stage of healing the patient is in- if NOT in the acute stage of an injury more than likely drugs will not help, it is not a chemical problem once you move into the sub acute and chronic stages. Find a GOOD PHYSICAL THERAPIST to help you understand your source of your problem and to get back to what you love to do.
These are general statements and there are some exceptions to these rules. Bottom line most of the people who come into my office are not sure what they did. So you really need to find a specialist physical therapist who truly understands the body to get to the source of the problem. Just fixing the pain is not the issue. Getting you back to being mobile and active is and that is what most healthcare providers are not looking at to determine what you are doing that is activity that could be creating your problem. We can. We specialize in helping people get back to what they love to do safely.
Do you have any QUESTIONS for us?
Did you know you can Schedule a call with one of our Physical Therapists to answer any of your questions to help you decipher what direction you need to go to with your pain and function. CLICK HERE to set up a time to talk.