Pain!

The March 7, 2011 edition of Time Magazine was devoted to the discussion of pain and ways to treat it. From spinal cord stimulation by implants, through drug therapies and finally by complementary and alternative medicine that attempts to minimize pain with minimal damage to the body.

Implants and narcotic drug therapies carry risks along with the possibility of easing pain. We are all aware now that what was once considered an innocuous pain reliever, acetaminophen, is known to cause liver failure when used in large doses. And, ibuprofen and other anti-inflammatory medications, even aspirin, can cause stomach bleeding.

In the area of pain management, medications do not heal the body. But in the hands of a competent physical therapist, that is, one who is licensed and who has a minimum of 10 years of experience and who works hands on with the patient for at least 30 to 40 minutes, physical therapy can alleviate pain, whether it is from a structural problem, an injury, or has been longstanding and chronic.

Physical therapy is derived from what was called physiotherapy and also from massage therapy. In my practice many massage techniques are used as well as yoga techniques. Every well trained physical therapist knows many different massage techniques; shiatsu, Swedish, deep tissue and uses them according to their assessment of the client. Many also incorporate the use of Eastern methods, like acupuncture. Western physical therapy concentrates on the manipulation of large parts of the body, Eastern style on small points, about one centimeter in width, manipulating them sometimes with fingers or laser or infra-red to either stimulate or cool down the points.

Whatever the path taken by the physical therapist, it is the hands-on  therapy that is of exceptional benefit to the patient. The hands of the physical therapist become his eyes and ears. For instance, if my patient is complaining of pain in the hip, I hold the hip and listen to the response from the body. If I feel the body is irritated and not moving as it should I start to cool down the body. If there is a lot of pain I am very careful, and use soft, gentle movement. If, on the other hand, there is not much pain I can be stronger and go deeper to see what is happening deeper in the patient’s body mechanics. And here, the patient needs to be the guide. For instance, if a chef cooks up spicy food and the diner cannot tolerate spicy food, then it is not a happy situation for the diner. And so it is with physical therapy, some patients prefer a slower, sure approach rather than a great deal at once. And I listen to the patient, no matter whether I believe differently.

Just as we have our primary care physicians and dentists who get to know our bodies and our problems, we also need to have a physical therapist we trust and visit him regularly so that he gets to know our bodies and can see when things are not as they should be and help correct the situation before it becomes a painful problem. I suggest a private physical therapist, one who does not work for a hospital or an insurance company so that the therapist is not constricted by what the insurance allows but who can spend time and do what is necessary. And what is of added benefit to the patient, a good physical therapist will make referrals to physicians if he suspects something for which a physical examination is necessary. For instance, some back pain can be from gynecological problems; shoulder pain can warn of an imminent heart attack.

So, if you are experiencing pain in your body for which your physician has no ‘cure’ or for which medication has not been the solution, consider physical therapy. But once again, I wish to say how important it is to find the right physical therapist for you. Ask people who are happy with their physical therapists. Try that person and if you are not satisfied, try another and another until you have found the one who helps you. Pain can destroy our lives. We don’t have to live with it. And one of the solutions may be just a phone call away to a physical therapist.