Back Pain Blog

Pain Psychology

Pain psychology is a service that is offered at Compass Health Rehabilitation Center. Patients are referred by their physicians for many different reasons, but basically the goal of pain psychology is to teach methods for coping with pain. Sometimes a patient who is sent for pain psychology will think, “I am in pain, not insane! Does my doctor think this is in my head?”

Pain psychology focuses on ways to help you live your best life despite pain. With chronic pain, there are often feelings of loss, due to limitations. There may be depression, because of having to fight pain daily, looking at a future that may be filled with pain, and having to cancel commitments because the pain is too severe. Many people also struggle with anxiety, secondary to pain, due to worrying about the pain lasting forever, the pain worsening, and whether the pain will stop them from being able to work and earn an income.

Friends and family members also struggle when a loved one is living with chronic pain. They can feel helpless, and want to offer advice, or make suggestions on what you can do to feel better. They may get angry when you have to cancel an event that they were also looking forward to. They may try to ignore that you have pain, resulting in a feeling that “no one understands my pain” or “no one cares that I am in pain’.

At times patients are referred for testing prior to a major surgery. This to determine if they are candidates for certain procedures, surgeries, spinal cord stimulators or other interventional methods. Patients are also referred for smoking cessation, due to the impact nicotine has on a person’s ability to heal after surgery.

Pain psychology includes psychotherapy, such as cognitive behavioral therapy, to learn how pain has an affect on your mood; including feelings, thoughts and behaviors. Psychotherapy educates and teaches ways to improve coping and self-management of pain. Treatments may also include mindfulness training, breathing exercises, relaxation techniques, and distraction methods to learn to decrease muscle tension and better manage pain.

Backpack Safety

With the return to school that has arrived so quickly upon us, for some you this may mean heavier loads to carry.The use of overweight and improper fit of backpacks may be a contributing factor for those with spinal pain.

Reminders when carrying backpacks

  1. Wear both straps. By wearing both straps you are evenly distributing the weight on both sides of your body. Shoulder straps that are well-padded can decrease pressure on your shoulders and neck. If there is a waist belt, use this as this will distribute the weight.
  2. Proper Position. Wear backpacks snugly in the middle of the back; it should not extend past your low back. Shoulder straps should be adjusted to allow for free motion with your shoulders and arms.
  3. Lighten the weight. Try and keep the weight at max 10-15% of your body weight. Put the heavier objects in the bag closest to your back. Take out what you don’t need.

If you do have pain, come see one of the physical therapists at Compass Rehabilitation. We can help correct posture dysfunction, improve muscle imbalances, and develop self management techniques that can result from improper backpack use.

Kristy Carpenter, DPT

  1. American Physical Therapy Association, Move Forward Physical Therapy (2014) Backpack Safety http://www.moveforwardpt.com/Resources/Detail.aspx; Accessed: 09/05/14

Concussions in Sport

What is a concussion? A concussion is an injury to the brain caused by a bump or blow to the head or a jolt of the head caused by a blow to the body that results in the brain bouncing around in the skull. This can cause a disruption to the way the brain works and have temporary or long lasting effects.

Though most athletes recover quickly, it can take others days, weeks or months to fully recover. Unlike a broken bone you can not see a concussion. It is crucial for the athlete to be evaluated by a healthcare professional trained to diagnosis concussions, before returning to play. On the field, coaching staff and athletic trainers should be trained to recognize the signs and symptoms of a concussion which are listed below. Once the brain is injured it is very important to allow time to fully recover to prevent long term problems.

Depending on the severity of the concussion, the athlete may experience sensitivity to light, noise, and other stimulating activity. He/she may have challenges returning to school and may need special accommodations to be successful in the classroom. This may include taking frequent rest breaks, requiring help or more time to complete tests or assignments, or spending less time reading, writing, or on the computer.

Signs and symptoms of a concussion:

Signs and symptoms of a concussion typically show up soon after the injury, however, symptoms may not show up for several hours or days. It is important to monitor an athlete who suffers a bump or blow to the head for 24 hours following the injury.

Symptoms the athlete may report include the following:

  • Headache
  • Nausea or vomiting
  • Dizziness or difficulty balancing
  • Vision disturbances
  • Sensitivity to light or noise
  • Trouble concentrating or remembering
  • Feeling dazed or mentally foggy
  • Difficulty recalling current events
  • Changes in sleep pattern
  • Confusion

Signs observed by the coach or athletic trainer:

  • Appears dazed or stunned or moves clumsily
  • Confused about directions
  • Forgets instruction
  • Unable to recall current events - score, opponent or where he/she is
  • Unable to recall events prior to or after injury
  • Slow to answer questions
  • Loss of consciousness
  • Mood changes
  • Perseveration – or fixating on a specific topic, asking the same questions over and over despite being given the correct answer

What to do if you suspect a head injury:

If you suspect an athlete has suffered a concussion remove him / her from the game and observe for the signs and symptoms mentioned above. It is important that the athlete be evaluated by an experienced health care provider. A coach or athletic trainer should record the following information which can assist the health care provider when assessing the athlete.

  • Cause of injury – explain in detail what happened
  • Loss of consciousness – note the time and monitor length of time unconscious
  • Loss of memory immediately following the injury
  • Occurrence of seizures if any – note the time and length of seizure
  • Number of previous concussions

Any athlete who is suspected of a having a concussion or exhibits one or more of the signs and symptoms must be evaluated by a health care provider experienced in dealing with concussions before returning to play.

For more helpful information on caring for an athlete who has suffered a concussion visit the Center for Disease Control or call 1-800-CDC-INFO.

Overuse Injuries

Have you been diagnosed with carpal tunnel syndrome, tendonitis, repetitive strain injury or are you having hand or wrist pain? Here is a roadmap to treating these conditions. The first step in healing is recognizing that you have a problem. Some questions you will want to ask yourself are:

  • Do your hands hurt after using the computer?
  • Do you find yourself dropping more items?
  • Are you constantly re-tying your shoelaces?
  • Do your hands hurt when you floss your teeth?
  • Are your hands or wrist hurting when you wake up, after driving, after playing videogames or using your smartphone?

Each of these problems often falls into what we call overuse injuries. Overuse injuries are slowly debilitating conditions that are the product of years of repetitive actions that eventually take a toll of your body. Studies have shown that there is no silver bullet or quick fix for these conditions.

The first step to recovery from these types of injuries is to find a competent hand surgeon, osteopathic physician or neurosurgeon to get a proper diagnosis.  Once you have a diagnosis from your physician, make sure you get a prescription for hand therapy.  Pain medications can have adverse effects, so take these with caution and only as prescribed by your physician. Surgery is a last resort and may only give temporary relief. From hand therapists, occupational therapists and physical therapists you will learn techniques including hot and cold transition baths, paraffin wax treatments, icing, wearing braces, wearing gloves, strengthening exercises, and ergonomics. These are far more useful than creating a dependence on medications. Keeping a log book or diary, documenting your pain and what activities you participated in that day that caused pain or lessened the pain is a helpful step to take. Hand message and relaxing activities come into play to help further your recovery process. Every therapist has a different approach, and some may work better than others for you, so do not hesitate to try a different hand therapist if the one you are using is not helping.  Education is key in treating these overuse injuries. Reading up on carpal tunnel and repetitive strain type injuries can give you the tools to help combat and eliminate your pain on a daily basis. An educated patient will recover quicker. Carpal tunnel syndrome and hand pain recovery will require changes in your life such as how you drive, bike, or even carry handbags or groceries. Any use of your hands will need to be examined and optimized to your new normal. Work changes such as computer ergonomics, different keyboards, input devices, chairs, desks, and other elements that require attention are important to prevent further damage. Electronic devises such as smartphones, iPods, gaming consoles, and computers can contribute to your hand pain. Touchscreens with their swiping gestures can cause undue hardship. Ergonomics and usage reduction are a must. Physician care, hand therapy, lifestyle, and work station changes are a collaborative approach to overuse injuries. All areas must be considered to have successful recovery without reoccurrence. Experts at The Compass Rehabilitation Center can review your concerns and options with you.