Pain Psychology

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June 12, 2015

Pain psychology is a service that is offered at Compass Health Rehabilitation Center. Patients are referred by their physicians for many different reasons, but basically the goal of pain psychology is to teach methods for coping with pain. Sometimes a patient who is sent for pain psychology will think, “I am in pain, not insane! Does my doctor think this is in my head?”

Pain psychology focuses on ways to help you live your best life despite pain. With chronic pain, there are often feelings of loss, due to limitations. There may be depression, because of having to fight pain daily, looking at a future that may be filled with pain, and having to cancel commitments because the pain is too severe. Many people also struggle with anxiety, secondary to pain, due to worrying about the pain lasting forever, the pain worsening, and whether the pain will stop them from being able to work and earn an income.

Friends and family members also struggle when a loved one is living with chronic pain. They can feel helpless, and want to offer advice, or make suggestions on what you can do to feel better. They may get angry when you have to cancel an event that they were also looking forward to. They may try to ignore that you have pain, resulting in a feeling that “no one understands my pain” or “no one cares that I am in pain’.

At times patients are referred for testing prior to a major surgery. This to determine if they are candidates for certain procedures, surgeries, spinal cord stimulators or other interventional methods. Patients are also referred for smoking cessation, due to the impact nicotine has on a person’s ability to heal after surgery.

Pain psychology includes psychotherapy, such as cognitive behavioral therapy, to learn how pain has an effect on your mood; including feelings, thoughts and behaviors. Psychotherapy educates and teaches ways to improve coping and self-management of pain. Treatments may also include mindfulness training, breathing exercises, relaxation techniques, and distraction methods to learn to decrease muscle tension and better manage pain.

Backpack Safety

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September 17, 2014

With the return to school that has arrived so quickly upon us, for some you this may mean heavier loads to carry. The use of overweight and improper fit of backpacks may be a contributing factor for those with spinal pain.

Reminders when carrying backpacks

  1. Wear both straps. By wearing both straps you are evenly distributing the weight on both sides of your body. Shoulder straps that are well-padded can decrease pressure on your shoulders and neck. If there is a waist belt, use this as this will distribute the weight.
  2. Proper Position. Wear backpacks snugly in the middle of the back; it should not extend past your low back. Shoulder straps should be adjusted to allow for free motion with your shoulders and arms.
  3. Lighten the weight. Try and keep the weight at max 10-15% of your body weight. Put the heavier objects in the bag closest to your back. Take out what you don’t need.

If you do have pain, come see one of the physical therapists at Compass Rehabilitation. We can help correct posture dysfunction, improve muscle imbalances, and develop self-management techniques that can result from improper backpack use.

Kristy Carpenter, DPT

References

American Physical Therapy Association, Move Forward Physical Therapy (2014) Backpack Safety http://www.moveforwardpt.com/Resources/Detail.aspx; Accessed: 09/05/14

Overuse Injuries

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May 21, 2012

Have you been diagnosed with carpal tunnel syndrome, tendonitis, repetitive strain injury, or are you having hand or wrist pain? Here is a roadmap to treating these conditions. The first step in healing is recognizing that you have a problem. Some questions you will want to ask yourself are:

  • Do your hands hurt after using the computer?
  • Do you find yourself dropping more items?
  • Are you constantly re-tying your shoelaces?
  • Do your hands hurt when you floss your teeth?
  • Are your hands or wrist hurting when you wake up, after driving, after playing videogames or using your smartphone?

Each of these problems often falls into what we call overuse injuries. Overuse injuries are slowly debilitating conditions that are the product of years of repetitive actions that eventually take a toll of your body. Studies have shown that there is no silver bullet or quick fix for these conditions.

The first step to recovery from these types of injuries is to find a competent hand surgeon, osteopathic physician or neurosurgeon to get a proper diagnosis.  Once you have a diagnosis from your physician, make sure you get a prescription for hand therapy.  Pain medications can have adverse effects, so take these with caution and only as prescribed by your physician. Surgery is a last resort and may only give temporary relief. From hand therapists, occupational therapists and physical therapists you will learn techniques including hot and cold transition baths, paraffin wax treatments, icing, wearing braces, wearing gloves, strengthening exercises, and ergonomics. These are far more useful than creating a dependence on medications. Keeping a log book or diary, documenting your pain and what activities you participated in that day that caused pain or lessened the pain is a helpful step to take. Hand message and relaxing activities come into play to help further your recovery process. Every therapist has a different approach, and some may work better than others for you, so do not hesitate to try a different hand therapist if the one you are using is not helping.  Education is key in treating these overuse injuries. Reading up on carpal tunnel and repetitive strain type injuries can give you the tools to help combat and eliminate your pain on a daily basis. An educated patient will recover quicker. Carpal tunnel syndrome and hand pain recovery will require changes in your life such as how you drive, bike, or even carry handbags or groceries. Any use of your hands will need to be examined and optimized to your new normal. Work changes such as computer ergonomics, different keyboards, input devices, chairs, desks, and other elements that require attention are important to prevent further damage. Electronic devices such as smartphones, iPods, gaming consoles, and computers can contribute to your hand pain. Touchscreens with their swiping gestures can cause undue hardship. Ergonomics and usage reduction are a must. Physician care, hand therapy, lifestyle, and work station changes are a collaborative approach to overuse injuries. All areas must be considered to have successful recovery without reoccurrence. Experts at The Compass Rehabilitation Center can review your concerns and options with you.

Pranayama: Stress Relief Yoga Breathing Technique

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May 14, 2012

Medical experts have long suggested that stress plays an important part in impacting our ability to function at maximal levels. Studies have shown that stress plays an important role in producing hormonal imbalance. This hormonal imbalance in the body can produce pain, muscle tension, soreness and anxiety attacks. Therefore stress relief can be an important step towards prevention as well as management to improve physical performance and quality of life.

The word Pranayama is derived from 2 Sanskrit words “Prana” meaning life force/vital energy/the breath and “Ayama” meaning control. Pranayama is a controlled breathing technique that helps in maintaining energy flow and balance in the body. Breathing is a very important element of life and controlled breathing is necessary for all kinds of successful exercises.

Proper respiration/ breathing provides energy to different body systems/parts as well as removes toxic waste products from our body. This promotes relaxation. Pranayama helps in maintaining oxygen and carbon dioxide balance in our body and thereby connects our body, mind and spirit. An individual under stress or stressful conditions usually does not pay much attention to proper breathing, and this can lead to fast and shallow breathing. The result can be oxygen deprivation, which increases negative energy and stress in the body.

Benefits of Pranayama:

Proper respiration is a critical part of an individual’s life. Pranayama allows an individual to breathe fully and deeply, which helps in improving lung capacity, oxygen saturation as well as optimal functional ability.

  • Pranayama increases an individual’s ability to concentrate by relieving stress as well as promoting relaxation, harmony and peace of mind.
  • Many believe that Pranayama prevents initiation or progression of any pathological or disease conditions.
  • Pranayama also improves one’s self-control.
  • Pranayama helps to remove body waste products/toxins.
  • Pranayama improves the rate of metabolism of the body and has been show to help digestion.

In our daily life, we use many relaxation techniques to relieve stress. Pranayama is a deep breathing yoga technique; which is easy to understand, less time consuming and also supported by various peer reviewed studies and articles.

Things to keep in mind while performing Pranayama:

  • Do not hold the breath during this exercise.
  • Pranayama techniques are best done on an empty stomach (Morning hours or one or two hours after a meal).
  • Move at your own pace and modify the poses as needed in order to maintain alignment and easy breathing in every pose.
  • If you feel any discomfort, dizziness or pain during your practice, either modify the pose so that you are comfortable or take a few moments to rest.
  • It is very important that you listen to your body and practice Pranayama techniques in the manner that is the safest and most comfortable for you.

At the Compass Rehabilitation Center, we have trained experts ready to discuss the benefits of Pranayama for you.

Office Ergonomics

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May 9, 2012

Do you ever feel achy, sore or painful after spending time on the computer? If you’re like many of us, your answer is, at least sometimes, yes! Thankfully, there are some basic guidelines that you can use to help yourself feel better and improve your tolerance.

Start with your keyboard. Ideally, this should be at your elbow level, so when your hands are on the keyboard, your forearms are level and elbows are at your sides. So adjust your seat height to that position.

If your seat back is adjustable, adjust the position to give you good low back support. Make sure the seat tilt is locked in the upright position. If you need additional back support, try a low back cushion or pillow.

The optimal position for your monitor is directly in front of you, with the top of your screen at eye level. If you use bifocals for computer work, the screen should be lower, so you can look through them without tipping your head back. If you are using a laptop computer and are having symptoms, try a monitor holder to raise the screen level and a separate keyboard.

Your distance from the monitor should be about an arms-length away but be sure to adjust it if needed so that you don’t need to lean forward to read anything.

If you use a separate mouse, its location should be just to the right or left of the Keyboard, to avoid overreaching.

With your hips all the way back in the chair, there should be 1-3 fingers of space in between the back of your leg and the seat edge.

Armrests are not mandatory for computer work. If present, should be slightly higher than the point of the elbow, and adjustable.

With your chair properly adjusted as above, if your feet are not supported well, use a footrest.

If you’re typing off copy (books or papers), they should be brought up to monitor height by using a document holder. In a pinch you can use a clipboard. Never flat!

For moderate to frequent phone use, a headset is recommended. Don’t hold between ear and shoulder.

Lastly, remember to sit all the way back in your chair and pull it up close to your work.

Happy computing!!!

Sleeping Positions and the Proper Way to Get Out of Bed

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May 8, 2012

The way you sleep at night can make a big impact on the way your back and neck will feel in the morning when you wake up. Many people are causing more back and neck pain from the way they sleep. Below are some helpful tips for making sure you have the most comfort during the night.

For back pain, you want to make sure your pelvis, hips, and spine are not twisted out of place when you sleep. A good way to take some stress off your back is to try sleeping on your back with some pillows under your knees, so that your knees are bent up. If you don’t like sleeping on your back, try lying on your side with a pillow between your knees, to keep your hips and pelvis even with each other.

For neck pain, the worst thing you can do is lie on your stomach with your head turned one way. This can tighten your neck on one side and cause stiffness or pain when you wake up. Instead, try lying on your back. If you’d like to lie on your side, try folding a pillow or using two pillows under your head to keep your neck even, so it doesn’t tilt to one side as you sleep.

When you get out of bed in the morning, it is best to start lying on your back or side. If you’re on your back, bend both knees up and roll to the side, so that your shins are off the bed. Use the arm closest to the mattress to push yourself up so that you’re sitting, and be sure to keep your body straight. Avoid twisting your trunk! If you’re lying on your side, simply dangle your shins off the bed and push yourself up to sitting.

Tips for Better Sleep

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May 7, 2012

Not getting enough sleep is bad for our health. Sleep insufficiency is linked to motor vehicle accidents, occupational errors, and chronic diseases such as depression, diabetes, hypertension, obesity, and cancer. According to the National Institutes of Health, the average adult obtains an average of less than 7 hours of sleep per night. The amount of sleep we need changes as we age and varies between individuals, but it is recommended that adults obtain 7-9 hours of sleep per night. The following are tips that can be used to help improve sleeping ability.

  1. Go to bed at the same time every night, and get up at the same time every morning, even on weekends
  2. Avoid large meals immediately before bedtime
  3. Avoid nicotine
  4. Avoid caffeine and alcohol near bedtime
  5. Include physical activity in your daily routine, though avoid vigorous exercise in the few hours before going to bed
  6. Limit daytime naps. If you must take daytime naps, limit them to 10-30 minutes, and avoid taking naps later in the afternoon or evening
  7. Create a relaxing bedtime routine, such as reading, taking a warm bath or shower, or listening to relaxing music
  8. Use your bedroom for sleep and sex only – avoid watching television or using computer while in bed
  9. Create a comfortable sleeping environment – get rid of distractions, such as noises or bright light, sleep on a comfortable mattress, keep the temperature cool
  10. If you frequently have trouble sleeping, contact your physician to identify and treat any possible underlying causes that may be preventing you from sleeping

Concussions in Sport

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June 6, 2012

What is a concussion? A concussion is an injury to the brain caused by a bump or blow to the head or a jolt of the head caused by a blow to the body that results in the brain bouncing around in the skull. This can cause a disruption to the way the brain works and have temporary or long lasting effects.

Though most athletes recover quickly, it can take others days, weeks or months to fully recover. Unlike a broken bone, you cannot see a concussion. It is crucial for the athlete to be evaluated by a healthcare professional trained to diagnosis concussions, before returning to play. On the field, coaching staff and athletic trainers should be trained to recognize the signs and symptoms of a concussion which are listed below. Once the brain is injured it is very important to allow time to fully recover to prevent long term problems.

Depending on the severity of the concussion, the athlete may experience sensitivity to light, noise, and other stimulating activity. He/she may have challenges returning to school and may need special accommodations to be successful in the classroom. This may include taking frequent rest breaks, requiring help or more time to complete tests or assignments, or spending less time reading, writing, or on the computer.

Signs and symptoms of a concussion:

Signs and symptoms of a concussion typically show up soon after the injury, however, symptoms may not show up for several hours or days. It is important to monitor an athlete who suffers a bump or blow to the head for 24 hours following the injury.

Symptoms the athlete may report include the following:

  • Headache
  • Nausea or vomiting
  • Dizziness or difficulty balancing
  • Vision disturbances
  • Sensitivity to light or noise
  • Trouble concentrating or remembering
  • Feeling dazed or mentally foggy
  • Difficulty recalling current events
  • Changes in sleep pattern
  • Confusion

Signs observed by the coach or athletic trainer:

  • Appears dazed or stunned or moves clumsily
  • Confused about directions
  • Forgets instruction
  • Unable to recall current events – score, opponent or where he/she is
  • Unable to recall events prior to or after injury
  • Slow to answer questions
  • Loss of consciousness
  • Mood changes
  • Perseveration – or fixating on a specific topic, asking the same questions over and over despite being given the correct answer

What to do if you suspect a head injury:

If you suspect an athlete has suffered a concussion remove him / her from the game and observe for the signs and symptoms mentioned above. It is important that the athlete be evaluated by an experienced health care provider. A coach or athletic trainer should record the following information which can assist the health care provider when assessing the athlete.

  • Cause of injury – explain in detail what happened
  • Loss of consciousness – note the time and monitor length of time unconscious
  • Loss of memory immediately following the injury
  • Occurrence of seizures if any – note the time and length of seizure
  • Number of previous concussions

Any athlete who is suspected of a having a concussion or exhibits one or more of the signs and symptoms must be evaluated by a health care provider experienced in dealing with concussions before returning to play.

For more helpful information on caring for an athlete who has suffered a concussion visit the Center for Disease Control or call 1-800-CDC-INFO.

Benefits of Traction

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May 4, 2012

When it comes to neck and back pain, there are many benefits from traction. During traction, your neck or low back are given a pull from a machine in order to stretch those areas. Treatments are usually ten to fifteen minutes long.

Traction is used to treat pinched nerves, neck and back tightness, and headaches. While in traction, the neck or the low back is stretched, and along with it, the spine is stretched a little as well. If you have pinched nerves in your spine, this can help take some of the pressure off and ease arm or leg pain. Traction is also good for treating bulging discs in your spine, which can also pinch your nerves if they lose enough water in the middle. By pulling your spine apart a little, traction can help the disc’s water and gel slip back into place.

Also, neck traction is good for treating headaches because it can stretch the muscles in the back of your neck and at the base of your skull. These muscles often cause headaches when they get too tight.

While traction is good for many conditions, there are some things it should not be used with, such as spinal fusion surgery, osteoporosis, and some spinal problems where the bones in your spine are slipping out of place.

Workstation Ergonomics

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July 18 2011

by Mike Marcin, PT

Many of us notice aches and pains when sitting at a desk for long periods.  These can be annoying at first, but can also turn into serious medical issues if not properly addressed.

Keep in mind, we have many things on our desks, and it is helpful to consider the impact of having them in the wrong position:

  • Monitor – should be an arms-length away to avoid slouching and gazing to see the screen
  • Keyboard – keep it close to you, are your elbows bent (preferred), or are they almost straight as you reach for the keyboard.
  • Document stand – these are helpful to avoid looking down at papers on your desk on a regular basis.  A document stand can be put next to the monitor or attached directly to a monitor
  • Mouse – keep your mouse as close to you as possible, preferably right next to the keyboard
  • Gel pads – these are helpful to avoid pressure on the wrist which can lead to problems such as carpal tunnel.  Gel pads are helpful in front of both the keyboard and mouse.
  • Phone – do you tip your head to hold the phone?  Do you hold the phone next to your ear for long periods?  If so, consider a headset to reduce stress on the neck.

Most importantly, try to get up and move every thirty minutes, stretch if you need to, and always sit up tall with good posture.

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