WHY DO PAIN PILLS, JOINT INJECTIONS, AND SPINAL DECOMPRESSION DON'T WORK ALL THE TIME? HOW CAN IT BE MORE EFFECTIVE? LET'S EXPLORE...
United States of America (Press Release) February 28, 2008 --
Pain affects millions of patients every day. Unfortunately, popping pills on a daily basis has become a normal routine for a significant percentage of our population. People with spinal and extremity pain have taken advantage of joint injections such as Cortisone or Epidural shots. Recently, some patients have tried spinal decompression to help them with their neck and low back pain.
Pain Pills, Joint Injections and Spinal Decompression
It’s true that patients have benefited from pain pills, shots, and spinal decompression. However, when patients report that the effects of these treatments are temporary or insignificant, we ask what could be the reason? Why do these treatments not work all the time? Could there a missing link that would make pain pills, joint injections, and spinal decompression more effective? Let’s explore.
Pain Pills
What happens after a pain pill is swallowed? It doesn't go directly to the spine or extremity, even though that's the place that hurts. Pain pills work through the body's nerve cells, nerve endings, nervous system, and brain to help relieve pain.
The body is full of nerve endings in the skin and tissues. When cells in the body are injured or damaged, they release a chemical called prostaglandin. The special nerve endings that sense pain are very sensitive to this chemical. When prostaglandin is released, the nerve endings respond to it by receiving and transmitting the pain and injury messages to the brain through the nervous system. They tell the brain everything about the pain, such as where it is and how much it hurts. The brain then perceives the pain.
When some pain relievers like ibuprofen are taken, it keeps injured or damaged cells from making and releasing prostaglandin. When the cells don't release this chemical, the brain doesn't get the pain message as quickly or clearly. So your pain goes away or becomes less severe for as long as the cells aren't releasing the chemical.
When pain is more severe, doctors may prescribe pain relievers that are stronger than acetaminophen and ibuprofen. These types of pain relievers work by getting in between the nerve cells so they can't transmit the pain message to one another. The message is unable to make it to the brain; this keeps the person from feeling pain.
Pain pills work in the body by altering the brain's pain receptors and blocking pain messages.
Joint Injections
Joint injections are usually a combination of a local anesthetic, or numbing agent, which provides immediate relief, and a corticosteroid, such as cortisone. Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland.
Cortisone shots reduce inflammation and can often relieve your pain for several weeks or even months at a time. It can produce dramatic results and is believed to work by blocking the body's natural inflammatory response. When pain is decreased from cortisone it is because the inflammation is diminished. However, the effects are temporary and do nothing for the underlying cause. Pain relief from the shot begins within a few days and may last for a few days or up to a month, but unless you address the cause, it will recur.
There is no rule on how many cortisone injections can safely be given in a year. However, animal studies have shown effects of weakening of tendons and softening of cartilage with cortisone injections. Therefore physicians limit the number of injections they offer to a patient.
An epidural steroid injection is very similar to a regular cortisone injection. This type of steroid injection places the powerful anti-inflammatory medication directly around the spinal nerves.
To administer the epidural steroid injection, the physician administering the shot will have the patient lie flat, face down, on an x-ray table. Using the x-ray to visualize the location of the tip of the needle, the doctor will guide the needle to an area very near to the spinal nerves, called the epidural space. Using the x-ray improves the likelihood that the medication will be given in the proper location. The epidural steroid injection lasts about 15 minutes; light sedation may be used if needed. More often, this treatment helps control the inflammatory process and may provide long-lasting relief.
SPINAL DECOMPRESSION
Spinal decompression is a non-surgical, non-invasive treatment for certain types of chronic back pain. Mechanical decompression works by slowly and gently stretching the spine, taking pressure off compressed discs and vertebrae. Decompression techniques provide relief by separating the bones of the spine, reducing the pressure within the disc (intradiscal pressure). Lumbar and cervical traction are techniques which physical therapists have used since World War II. Decompression combined with specific positioning takes pressure off structures in the back and neck that are causing pain.
PHYSICAL CAUSE OF PAIN
Pain due to trauma, injury, or as a consequence of physical dysfunction will cause the muscles’ guard to protect itself from the pain. Muscle guarding creates muscle tightness. When the muscles become tight, the covering of the muscles, called “fascia” or soft tissue, also becomes tight, making the muscles even tighter. When that occurs, the joint(s) in the spine or extremity also become tight and restricted. Then the levels above and/or below the joint restriction(s) in the spine (the surrounding structures to the extremity) will pull and stretch every time a movement is initiated. The pulling and stretching always leads to pain. Muscle tightening increases and the cycle continues. Therefore, when movement restrictions in the spine are not examined, discovered, and identified, the pain will always be there. As long as movement restrictions are present in the spine and extremities, there will always be compensation. Hence, there will always be PAIN.
THE MISSING LINK
Orthopedic Manual Physical Therapy is a specialty in physical therapy that includes the evaluation and treatment of physical dysfunctions. Dysfunction is defined as aberrant movements which can be due to an abnormal decrease (hypomobility) or increase (hypermobility) of movement in the spine or extremities.
Orthopedic physical therapists are skilled and trained to detect abnormal movements which may be present in the neck, back, arms and legs. Through orthopedic physical therapy testing such as Passive Intervetebral Motion Testing (PIVM) of the spine, orthopedic physical therapists are able to detect and identify the hypomobile structures that may be causing the patient’s physical pain. The PIVM Testing serves the same purpose as a stethoscope. The treatment rationale is to mobilize the hypomobile joints through joint mobilization and to strengthen and stabilize the hypermobile structures through exercises.
HOW CAN ORTHOPEDIC MANUAL PHYSICAL THERAPY MAKE PAIN PILLS, JOINT INJECTIONS, AND SPINAL DECOMPRESSION MORE EFFECTIVE?
Summarizing the physical cycle of pain, unless the movement restrictions in the spine and extremities are examined, identified, discovered, and treated, pain will always be present…As long as there is movement restriction, there will always be compensation; there will always be pain.
When this is the case, pain pills and injections will just be masking the pain and the results will just be temporary. However, when the mobility of the joints, muscles, and soft tissues are regained and maintained, what is there to pull? Absence of limited movements will lead to decreased compensation, resulting in less or no pain. Therefore, pain pills and injections shots will be more effective and better results can be expected.
For spinal decompression to take effect, the bones of the spine would have to separate. When joint mobility in the spine is restricted prior to treatment, two things can happen: 1, There will be more pulling and stretching, therefore more pain; and 2, Spinal decompression will not be that effective. Therefore, normal mobility of the spine prior to this treatment will maximize the efficacy of spinal decompression.
CONCLUSION
Pain management is complex. There is no single approach to treatment that can solve the problem. To get the best result in treating pain, it takes a combination of techniques.
Pain Pills, Joint Injections and Spinal Decompression
It’s true that patients have benefited from pain pills, shots, and spinal decompression. However, when patients report that the effects of these treatments are temporary or insignificant, we ask what could be the reason? Why do these treatments not work all the time? Could there a missing link that would make pain pills, joint injections, and spinal decompression more effective? Let’s explore.
Pain Pills
What happens after a pain pill is swallowed? It doesn't go directly to the spine or extremity, even though that's the place that hurts. Pain pills work through the body's nerve cells, nerve endings, nervous system, and brain to help relieve pain.
The body is full of nerve endings in the skin and tissues. When cells in the body are injured or damaged, they release a chemical called prostaglandin. The special nerve endings that sense pain are very sensitive to this chemical. When prostaglandin is released, the nerve endings respond to it by receiving and transmitting the pain and injury messages to the brain through the nervous system. They tell the brain everything about the pain, such as where it is and how much it hurts. The brain then perceives the pain.
When some pain relievers like ibuprofen are taken, it keeps injured or damaged cells from making and releasing prostaglandin. When the cells don't release this chemical, the brain doesn't get the pain message as quickly or clearly. So your pain goes away or becomes less severe for as long as the cells aren't releasing the chemical.
When pain is more severe, doctors may prescribe pain relievers that are stronger than acetaminophen and ibuprofen. These types of pain relievers work by getting in between the nerve cells so they can't transmit the pain message to one another. The message is unable to make it to the brain; this keeps the person from feeling pain.
Pain pills work in the body by altering the brain's pain receptors and blocking pain messages.
Joint Injections
Joint injections are usually a combination of a local anesthetic, or numbing agent, which provides immediate relief, and a corticosteroid, such as cortisone. Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland.
Cortisone shots reduce inflammation and can often relieve your pain for several weeks or even months at a time. It can produce dramatic results and is believed to work by blocking the body's natural inflammatory response. When pain is decreased from cortisone it is because the inflammation is diminished. However, the effects are temporary and do nothing for the underlying cause. Pain relief from the shot begins within a few days and may last for a few days or up to a month, but unless you address the cause, it will recur.
There is no rule on how many cortisone injections can safely be given in a year. However, animal studies have shown effects of weakening of tendons and softening of cartilage with cortisone injections. Therefore physicians limit the number of injections they offer to a patient.
An epidural steroid injection is very similar to a regular cortisone injection. This type of steroid injection places the powerful anti-inflammatory medication directly around the spinal nerves.
To administer the epidural steroid injection, the physician administering the shot will have the patient lie flat, face down, on an x-ray table. Using the x-ray to visualize the location of the tip of the needle, the doctor will guide the needle to an area very near to the spinal nerves, called the epidural space. Using the x-ray improves the likelihood that the medication will be given in the proper location. The epidural steroid injection lasts about 15 minutes; light sedation may be used if needed. More often, this treatment helps control the inflammatory process and may provide long-lasting relief.
SPINAL DECOMPRESSION
Spinal decompression is a non-surgical, non-invasive treatment for certain types of chronic back pain. Mechanical decompression works by slowly and gently stretching the spine, taking pressure off compressed discs and vertebrae. Decompression techniques provide relief by separating the bones of the spine, reducing the pressure within the disc (intradiscal pressure). Lumbar and cervical traction are techniques which physical therapists have used since World War II. Decompression combined with specific positioning takes pressure off structures in the back and neck that are causing pain.
PHYSICAL CAUSE OF PAIN
Pain due to trauma, injury, or as a consequence of physical dysfunction will cause the muscles’ guard to protect itself from the pain. Muscle guarding creates muscle tightness. When the muscles become tight, the covering of the muscles, called “fascia” or soft tissue, also becomes tight, making the muscles even tighter. When that occurs, the joint(s) in the spine or extremity also become tight and restricted. Then the levels above and/or below the joint restriction(s) in the spine (the surrounding structures to the extremity) will pull and stretch every time a movement is initiated. The pulling and stretching always leads to pain. Muscle tightening increases and the cycle continues. Therefore, when movement restrictions in the spine are not examined, discovered, and identified, the pain will always be there. As long as movement restrictions are present in the spine and extremities, there will always be compensation. Hence, there will always be PAIN.
THE MISSING LINK
Orthopedic Manual Physical Therapy is a specialty in physical therapy that includes the evaluation and treatment of physical dysfunctions. Dysfunction is defined as aberrant movements which can be due to an abnormal decrease (hypomobility) or increase (hypermobility) of movement in the spine or extremities.
Orthopedic physical therapists are skilled and trained to detect abnormal movements which may be present in the neck, back, arms and legs. Through orthopedic physical therapy testing such as Passive Intervetebral Motion Testing (PIVM) of the spine, orthopedic physical therapists are able to detect and identify the hypomobile structures that may be causing the patient’s physical pain. The PIVM Testing serves the same purpose as a stethoscope. The treatment rationale is to mobilize the hypomobile joints through joint mobilization and to strengthen and stabilize the hypermobile structures through exercises.
HOW CAN ORTHOPEDIC MANUAL PHYSICAL THERAPY MAKE PAIN PILLS, JOINT INJECTIONS, AND SPINAL DECOMPRESSION MORE EFFECTIVE?
Summarizing the physical cycle of pain, unless the movement restrictions in the spine and extremities are examined, identified, discovered, and treated, pain will always be present…As long as there is movement restriction, there will always be compensation; there will always be pain.
When this is the case, pain pills and injections will just be masking the pain and the results will just be temporary. However, when the mobility of the joints, muscles, and soft tissues are regained and maintained, what is there to pull? Absence of limited movements will lead to decreased compensation, resulting in less or no pain. Therefore, pain pills and injections shots will be more effective and better results can be expected.
For spinal decompression to take effect, the bones of the spine would have to separate. When joint mobility in the spine is restricted prior to treatment, two things can happen: 1, There will be more pulling and stretching, therefore more pain; and 2, Spinal decompression will not be that effective. Therefore, normal mobility of the spine prior to this treatment will maximize the efficacy of spinal decompression.
CONCLUSION
Pain management is complex. There is no single approach to treatment that can solve the problem. To get the best result in treating pain, it takes a combination of techniques.
Email
Print
SPAM
