Physical Therapy in Kalaheo and Kapaa for Womens' Health Issues

Welcome to Ohana Sports Medicine's resource on chronic pain.

Chronic pain is generally classified as pain that lasts for longer than 6 months [1].  While there are many possible causes, one is thought to be due to problems with some of the receptors found throughout the body that receive and transmit information from your five senses to your brain. Alternately there may be a problem with how the receptors of the central brain and nervous system interpret the information they receive [2].  Common complaints include joint pain from arthritis, headache, low back pain or pain associated with cancer.  There is also the chronic pain that seems to have no real cause but is just as severe and debilitating as pain with a known cause.
 
Research has shown that women deal with chronic pain longer and more often than men.  Women also feel pain more intensely [3].  Therefore it should come as no surprise that women are 1.5 times more likely to have headaches and neck, shoulder, knee or back pain; two times more likely to have oral or facial pain; 2.5 times more likely to suffer from migraines and four times more likely to have fibromyalgia [4].

 

The complexity of chronic pain requires a thorough medical work up to determine the factors contributing to the condition as well as to match the underlying condition with the appropriate treatment.  The goals of the chosen treatment may include general pain relief, improvement in function and mobility, and psychological and emotional strategies to cope with the pain.  It is also important to prevent secondary musculoskeletal conditions.  Months or years of pain can alter muscles, joints, and nerve sensitivity, resulting in changes in posture, strength and mobility.
 
The goal of chronic pain treatment is to improve the quality of life of the patient.  This might mean giving them the skills to cope with some measure of pain, including sleeping tips, stress-reducing tips, and things that can be done to help them return to more regular activities.
 
Some of the more common treatments for chronic pain include:

Physical Therapy

Physical Therapy encompasses many different types of treatment starting with a comprehensive evaluation of your body’s systems, mobility and functional abilities. Based on those findings, your physical therapist will choose specific techniques and interventions appropriate for your condition.  These may include manual therapy to increase range of motion of joints, ligaments and muscles; exercises to maintain strength, flexibility and mobility; postural correction; hands-on soft tissue mobilization; modalities such as interferential, cold laser, heat or cold therapies.  One of the most important interventions you can receive is education about the origins of chronic pain and the brain’s response to pain over time.  The book Explain Pain by David Butler and Dr. Lorimer Moseley is an extraordinary book for clients to understand the response of the brain to pain and how to change it.
 
Physical Therapy as a treatment for chronic pain can be very effective as it encompasses many of the other treatments discussed. It has also been shown that receiving encouragement from a therapist during treatment will increase motivation and ultimately improve results [18].  By working with a pelvic Physical Therapist, instead of on your own, you will receive a customized rehabilitation program as well as encouragement and accountability to carry on with the treatment. Working with a highly trained pelvic physical therapist gives you a better chance of success.    
 
Ohana Sports Medicine provides services for pelvic Physical Therapy in Kalaheo and Kapaa.

Exercise

It is critical that your health care provider refer you to a physical therapist for a clinician-directed therapeutic exercise program designed especially for your needs.  There are a variety of exercises and activities that increase strength, range of motion and mobility but they must be appropriate for you and your needs. By performing gentle stretching or non-weight-bearing exercises such as swimming regularly, your muscles and joints will get stronger.  A study performed in 2006 showed that patients with chronic low back pain benefited from a specific Pilates-based exercise program [9].

Neural Downregulation

Neural downregulation is the technical term for treatments that change the messages the brain sends the body about pain and discomfort.  Things such as yoga, meditation, guided imagery, biofeedback and cognitive behavioral techniques play a critical role in changing the brain’s response and perception of pain.  The patient can use these techniques to choose their response to pain, which may result in a reduction of perceived pain levels.  These techniques can be a complement to more traditional therapies and have been shown to benefit people suffering from chronic pain [10,11].  In a 2008 study by Carrico, participants with chronic pelvic pain listened to a guided imagery CD which resulted in significant reduction in urinary urgency and pain in individuals with interstitial cystitis [12].

Healthy diet

A diet rich in vitamins and minerals and other needed nutrients and low in fat and sugar can help reduce pain.  In cases of pain caused by IBS, a diet high in fiber has been shown to be beneficial [13].  Optimizing your nutrition by avoiding processed foods and alcohol, as well as emphasizing lean protein, vegetables and fruits will not only reduce risk of further disease, but improve overall health.  Caffeine can elevate levels of anxiety and stress, which can thereby increase myofascial pain.  Conversely, caffeine has been shown to increase the pain-killing effects of aspirin and acetaminophen (Tylenol) by 40% [14].

Pain and physical discomfort are not a normal part of life. If you are affected by these or any other conditions, the professional Physical Therapists at Ohana Sports Medicine would be happy to talk to you and answer any questions you may have about whether Physical Therapy is right for you.

1. Thienhaus O, Cole BE. Classification of pain. In Weiner, R.S. Pain management: a practical guide for clinicians (6 ed.). American Academy of Pain Management. 2002.
2. Keay KA, Clement CI, Bandler R. The neuroanatomy of cardiac nociceptive pathways. In Horst, GJT. The nervous system and the heart. Totowa, New Jersey: Humana Press. 2000. p. 304.
3. Kelly JF. Translating research on chronic pain in women to practice. 118th Annual Convention of the American Psychological Association. 2010 Aug; San Diego, California.
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18. Vong SK, Cheing GL, Chan F, So EM, Chan CC. Motivational enhancement therapy in addition to Physical Therapy improves motivational factors and treatment outcomes in people with low back pain: a randomized controlled trial. Arch Phys Med Rehabil. 2011 Feb;92(2):176-83.