Health Insights column: Instead of ‘tidying up’ a pain problem, reach for the source
September 5, 2016
We live in a disposable age. We don't bat an eye when a $600 cell phone lasts exactly two years. If a small appliance fails, it's easier to buy a new one than to figure out what went wrong. From counter wipes to coffee cups, we throw piles away. The term is "planned obsolescence." The goal is to make a product or part that will fail or become less desirable over time or after a certain amount of use.
Have we learned to view or bodies in the same manner? If our feet hurt, we fix the problem with orthotics. If a joint "goes out" we have someone crack it back into place. When we suffer from tendinitis, we get relief with injections. If our knees have arthritis, we can get new ones.
I call it bento box health care. Are we just tidying up the problem?
Becoming a body brat
The only way to treat the problem is to treat the individual.
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I can speak from personal experience. Years ago I tweaked my back lifting something awkward and heavy. For relief, I sought massage, experienced electrical stimulation and received various mobilizations. I followed my core strengthening routine. As the pain came back, I had a few injections to quiet the pain. From time to time, my sacroiliac joint (in the pelvis) would get stuck. I got dry needled, manipulated and pieced together with kinesio tape. The problem is that the pain always came back. It got to the point where I felt ancient when I got out of a chair, and my back began to make unwelcome noises.
I was a good example of the shoeless cobblers' child. I spent my time trying to help repair others, yet there I was, quite broken. I had gone down the path of allopathic medicine. You fix me. I was what I'd call a body brat. I wanted to do what I wanted to do. If I hurt, I wanted someone to take my pain away.
Science and art
I was accustomed to protocols, clinical prediction rules and evidence-based medicine. "The research supports X," "people with X pain do well with Y exercises," etc. Here's the problem: No two people are the same. I was accustomed to relying on the science of medicine and had ignored the most important part: the art of medicine.
What I needed was investigation and exploration. I had been focusing on my "what" when I really needed to figure out the "why." I could talk paint off the wall with my findings. My sacroiliac joint stuck because my hip couldn't drop thanks to how I pushed off with my right foot. I had learned to lift with my back instead of my legs. There was too much tension in my hip flexors and not enough in my core. I had some active scars and a sluggish diaphragm. I had learned to move almost exclusively in one of the three planes of motion. Like everyone else with pain, I had a diverse collection of dysfunctions.
It has taken thought, peeling layers and hours and hours of exploration. I am respectful of the science of medicine, but more grateful for the art.
exploration and treatment
With 360 joints and several thousand muscles, we have vast options beyond tight, weak or broken. With exploration, we can often restore what is seemingly damaged. A knee problem might really be a foot problem. A foot problem may, in turn, be a core problem. Carpal tunnel in your wrist may stem from issues in your neck. The only way to treat the problem is to treat the individual.
"Our stories are ourselves. We use them to describe to others our needs, and health care is no exception. Mainstream medicine has a challenge: Continue to ignore the patient's story and lose them to a subjective fantasy built of the mistakes of our mammalian brain, or join the patient as a supporting character in their life, allowing science to sort out the fantasy and improve the patient's life while making them the hero in their story of healing." — Michael Kruse, "The Power of Narrative Medicine," Huffington Post Aug. 28, 2013
Julie Peterson, MPT, is the owner of Concierge Physical Therapy Colorado. She is a certified neurokinetic therapy specialist with a strong background in manual therapy. She can be reached at 970-306-3006 and firstname.lastname@example.org. For more information, visit http://www.conciergeptcolorado.com.