So often when a patient comes in with a neck or back complaint, they state that they can’t recall anything happening that caused the problem. That’s because they are thinking that nothing happened recently– car accident, fall off a ladder, etc. What tends to be the case in the majority of patients is that they are hurting because of the cumulative effects of daily life stresses (physical and mental), chronic
poor posture, and lack of exercise. So, an important part of the treatment is identifying what needs to change in their daily life as we look to partner in the care of their spine.
One of the most common sense ways to help manage a musculoskeletal condition is to minimize stress on the area that is susceptible by improving one’s posture. Sleeping on the stomach, talking on a phone while holding the receiver between an ear and shoulder, and bending incorrectly at the waist are just three examples of things we all do that put our backs and necks at risk. When we do these things on a daily/nightly basis it invariably leads to some degree of discomfort. If a patient is willing to break the habit of sleeping on their stomach, it pays dividends down the road as regards to the health of their neck. Acquiring a headset at work, when they have to be on the phone all day, is always helpful. As for bending/lifting/etc., we all know the right way to do it but, unless we are already experiencing back pain and want to make sure to protect our back, we often forget. Bend wrong enough times and something is going to give – guaranteed. In an effort to help a patient think about pain management, I encourage them to always bend like they did when they have hurt in the past. If a painful back can handle bending at the hips, it makes common sense that it is probably just as good for a back that isn’t hurting. (Again, pain is the motivator, so it takes some discipline to get into the habit of following good habits when the motivation isn’t present, but those patients who get into the habit of taking care of their backs are not showing up in at the chiropractor’s office over and over suffering another flare-up.)
It’s common sense to get moving as soon as possible, as much as able to based on the condition at the time. People don’t need to exercise strenuously, but they do need to make a consistent effort to get their joints active. Sitting or lying around waiting for every vestige of discomfort to disappear before attempting to stretch/exercise is, in the long run, counterproductive. As with proper posture, regular exercise is a critical component in helping manage a person’s pain. This is the best “medicine” for one’s back, helping address both physical and mental stress.
The stress of dealing with pain can obviously affect one’s ability to get restorative sleep. Once a patient begins to feel better they usually will sleep better, but occasionally other factors are contributing to poor sleep hygiene, so often there is a need to refer for a sleep study. Patients who don’t sleep well tend to not get well, so this must be addressed early on in one’s treatment.
Managing pain successfully requires that the patient take action by following recommendations given, whether it’s reaching for medication or getting off the couch to exercise. I never tire of a patient telling me that they have been doing well since we last met. Those who take some personal responsibility for their healthcare are usually the ones who can say that.
What is common sense pain management? Being pro-active with the patient’s participation to avoid having to put out the same fire again and again.
Steven Vollmer, DC, DAAPM, a native Memphian, has been in practice since 1987. He is a doctor of chiropractic and Diplomate of the American Academy of Pain Management. He has post-graduate training in neurology and sports injuries and has a special interest in pain management. Dr.Vollmer can be reached at Cole Pain Therapy Group in Bartlett at 901-377-2340.