Pain relief from manual therapy

Manual Therapists [physiotherapists, chiropractors, osteopaths, massage therapists, acupuncturists]  are genuinely intent on patients experiencing pain relief.  But patients with long-term pain need to realise that therapists can only relieve the pain – they cannot diagnose, fix or cure the whole chronic pain condition!

Therapists ask for and listen carefully to the current symptoms. They differ from most doctors in that they locate the area where the pain is stemming from and they work on the problem with their hands according to their specific discipline. It can really surprise me to find out that the source of my problem is in another part of my body. I often take a permanent marker and get them to mark crosses on my back so that when I get home I can see in the mirror where the offending sites are. Therapists also give valuable recommendations for managing the recovery from a painful episode – certain types of exercise, avoidance of certain activities, applying ice etc. Now that I have a proven way of treating pain with microcurrent therapy I still learn so much from them about the optimal site to place electrodes. This helps me to follow through on the pain relief I gain from an appointment. I highly recommend going to a therapist in times of dreadful pain as the information they supply will help you to manage your pain as much as the treatment they give.

I turned to a chiropractor in 1988 after my GP could not determine what was the matter with me and could only recommend paracetemol which seemed completely ineffective in diminishing the pain. At the time if felt like my right buttock and leg were on fire. In fact chiropractic treatment was the only thing that afforded me pain relief – not massage, not exercise, not tablets, not rest, not physiotherapy. It took years before it became clear that there was an underlying systemic condition and not just unrelated parts of my body breaking down. No wonder therapists would suggest conditions or injuries as they worked piecemeal on my body : whiplash, RSI, piriformis syndrome, sprained ankle, sciatica, stress, all-over muscle tightness, a very tight iliopsoas, tennis elbow and candida. This of course would lead to admonitions about having the correct posture, becoming more relaxed, changing my whole lifestyle, building core body strength, undergoing a course of dry needling, trigger point therapy or direct myofascial release, doing a detox, changing my diet, taking supplements, stretching and lengthening various muscles. I did all of this and more!

I should just say here that different therapists may describe my symptoms differently. Whereas the chiropractor may refer to the L5S1 joint, the physiotherapist will talk about the hip flexor muscle and pelvic girdle and the massage therapist might notice that the gluteus maximus is tight and another might talk about the need to strengthen weak abdominal muscles. I can always look up these terms under ‘Images’ on the internet to get a clearer idea when I get home from an appointment.

Appointments with therapists take time and money, and there can be one massage therapist, for instance, who really helps and another  who is useless. It will be a matter of trial and error. And money. There are additional things therapists may recommend such as taping a part of the body to immobilise it (absolutely the wrong thing for me!) or buying a foam roller (agony for my iliotibial band!) or a special BakBall (2 joined balls) to undo the nerve tension in my spine (too severe!). More money, appointments and frustration.

Examples of therapeutic aids that are ineffective for my condition

Examples of therapeutic aids that were ineffective for me

Here are some other things I spent my money on to no avail:

  • I really couldn’t tell if the Piezo  (needle-less acupuncture device) had any benefit.
  • Dry needling seemed to do nothing.
  • Cupping might have been slightly beneficial but I now steer away from glass fire cupping since I once got burnt – this meant I could not apply the electrodes to that area until the skin healed.
  • Ultrasound seemed to inflame the area and it took ages for the inflammation to subside.
  • Various back supports seemed to push into my spine at the wrong site and accentuate the pain.
  • Cranial osteopathy resulted in severe headaches.
  • Some acupuncture worked slightly and some was too strong and brought on headaches. A ‘course’ of acupuncture seemed to deliver pain relief in the lower half of my body but after I stopped treatment the pain simply regrouped and manifested itself with the same intensity. If I was able to have acupuncture every single day then perhaps …

Some things were worth the money:

  • I bought the Trigger Point Therapy Workbook to understand where pain might be radiating from.
  • A handheld Squirrel Massager for tight and aching muscles has been beneficial.
  • A new kind of tape – Kinesiology tape – which supports the problem area but does not restrict it.
Trigger Pont book and Squirrel Massager were beneficial

Trigger Pont book and Squirrel Massager are helpful for me

When I was still extremely confused about all the pain I was experiencing it was a physiotherapist who suggested that it was not normal for me to have such strong pain for the type of muscle tightness and joint restriction that kept recurring. I got a referral to a Pain Clinic in Auckland and this lead to an initial diagnosis of fibromyalgia. I now have doubts about this diagnosis but it was a help for me to understand that there was ONE actual syndrome to explain all the diverse ailments I was suffering.

In earlier years I would often feel frustrated and disappointed after a physical therapy treatment – either it stirred up the pain or it did not do enough to alter the pain. Now I have different and more reasonable expectations. Why should I expect therapists to make me better when doctors have not been able to? I have come to realise that I must not expect solutions to the pain but that I will probably get some pain relief which will gradually help me to pull out of a very strong episode of pain.

And nowadays I don’t enrol therapists in a detailed history of my chronic pain. I am the person who is most able to manage the different areas of my body that are involved.  I limit myself to the particular site that is giving me the most pain. I get as much information as I can from the therapist and then I go home and experiment with the Painmaster patches until I find the optimal site that will bring the maximum pain relief. See an earlier post on Mastering Pain.

Painmaster

Painmaster

You can also refer back to the Number 1 Principle For Reducing Pain which supports manual therapy if it brings you pain relief. Constant pain is the driver of chronic pain so if you can find any way to reduce pain by a therapist’s treatment then you are allowing your nervous system time to rest. It’s such a blessing to find a good therapist!

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