Common Sense Pain Management

Common Sense Pain Management

  - Dr. Steven Vollmer

Partnering with your chiropractor in the effort to get the complaint under control and keeping the pain away is important in common sense pain management. The optimum approach to a problem is to find out what led to it and then, after successfully treating the pain, provide the advice and direction needed in order to help minimize the chances of suffering future flare-ups. If the patient owns that way of thinking and does their part, I find that I am not seeing them over and over for treatment of the same complaint.

We have all been told since childhood that it is important to brush our teeth twice a day and floss, in addition to seeing a dentist for checkups every six months. In spite of the fact that all dentists would testify that many, if not most, of their patients don’t follow that advice, I am certain that most people take care better of their teeth than they do their spines. Unless we are experiencing unrelenting pain, we usually don’t give our backs/necks much thought. Teeth are visible to all when one opens his or her mouth, so how they appear is of social importance to people, while that pesky backbone is hidden away. However, unlike our teeth, which can be replaced if necessary, we are all stuck with the spine God gave us, and continually ignoring its health and function can ultimately lead to some serious problems with long-lasting detrimental effects.

Chiropractors specialize in finding spinal misalignments and correcting them through manipulative therapy. Many people, usually those who have never received chiropractic care, think that once you go to one of us you will be going for the rest of your life, so the best thing is to never start. Well, I return to my reference to dentists and oral hygiene. Most people who want to properly take care of their teeth go to a dentist on a regular basis so the doctor can check for and treat developing conditions that their brushing and flossing are not adequately handling. Why, then, should seeing someone for periodic spinal care be considered such a farfetched concept? It isn’t, especially when one realizes what an important role the spine plays in our being able to function properly. There is no cure for back or neck problems, no guarantee that misalignments and the complications that can ensue from them won’t return. So, in the effort to manage pain, spinal checkups/treatments are invaluable.

Many patients feel that, once their pain is gone, so is the problem that caused it. They believe that their pain has been managed and, to a degree, for that particular episode anyway, it has been. But the pain that brought them to the doctor is not their real problem, but rather the result of a problem that needs to be addressed. It’s like a fire alarm going off when it detects smoke. The alarm is obviously not the problem. Pain is a great motivator, particularly when it is acute, and once the pain is gone, or greatly diminished, the motivation to take care of the neck/back is usually gone as well. Unfortunately, this way of thinking is what sets someone up for another bout of the same problem down the road.

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 with the knees, 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.