Healthcare will always develop and evolve like any of scientific field, the differences these changes make, may impact you and help you understand your pain better! These are also the three areas I get the most questions about!
Many reading this blog will remember the days when back pain, especially with any sciatic nerve involvement, meant 6 weeks off work, bed bound with a big dose of strong painkillers. However, times are changing and so is our understanding of back pain. More than 80% of us will experience back pain in our lives and over 80% of that pain will not be the result of disease, damage or pathology. Rather back pain is caused by a variety of contributing factors such as; lack of movement, stress, poor sleep and soft tissue dysfunction. As a Physiotherapist, we are on the frontline for treating back pain as we have the skills to assess, diagnose and devise effective treatment plans to keep back pain at bay.
Less need for imaging
It’s not uncommon for people to ask me – Should I get a scan on my back or do I need an MRI on my shoulder? It’s a good question but scans are only part of the answer. Throughout assessment and treatment, I will work to understand what the issue is and what is the best treatment. A scan, whether it’s an MRI, CT or X-ray is simply an academic report. It’s done by a talented radiographer, often in partnership with a consultant and reports what they see. BUT, what the report does not acknowledge is the person. On countless occasions we read scans showing lots of degeneration or “wear and tear” but the patient in front of me is pain-free and still playing golf off a 3 handicap. On other occasions, I see people in pain with less structural damage. This does not mean their pain is not real, rather, that the physical structures are not only to blame, or as some Physio’s say- The tissue is not always the issue!
Tendinopathy not Tendonitis
In recent years, lots of money and time has been spent investigating why people get tendon pain. This occurs commonly in the Achilles, the forearm (golfers and tennis elbow) or in the rotator cuff muscles in the shoulder. This new wave of research has led to some new findings. Tendon pain is not the result of inflammation, but rather a spike in use of that tendon which means the tendon is too weak for the new demand. When a tendon is weak and we still ask it to work hard, it causes lots of different chemicals to release, which may create swelling or pain. Hence us Physiotherapist’s will often say tendinopathy as the “itis” in tendinitis refers to inflammation. What this means for you is that anti-inflammatory treatments may prove less effective than progressively strengthening the tendon.
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