Specializing in work injuries and in motor vehicle related injuries

Physical

Medicine

Northwest            

  What is pain?

A survival mechanism.  The experience of pain alerts us to injury or potential injury.  Those very few people who are insensitive to pain incur many injuries.  Nearly any part of the body can become painful.  Specialized nerves at the site of damaged tissue transmit impulses to the spinal cord.  From there, impulses travel to the thalamus in the center of the brain, and then to multiple sites throughout the brain.  These various sites identify that a potentially destructive event has occurred and decide what to do about it.  The pain processing system is complex.  A person's experience of pain is unique to that person composed of many inputs such as current state of health, previous experiences with pain, and mental condition.     

Imaging studies such as x-ray, CT, ultrasound, and MRI show anatomical structures but not pain.  The description of pain and findings on physical examination determine if what is seen in an imaging study is important.  Generally, after the age of 20 degenerative changes can be seen in the spine which gradually become more obvious as we age, are not necessarily painful, and may be difficult to separate from the effects of an injury.    

  What is the best treatment?

The best treatment, of course, is that which provides the maximum degree of recovery.   Typically, treatment during early recovery is passive such as taking a medication or having massage therapy.  As recovery progresses treatment becomes more active and rehabilitative to restore strength and flexibility lost during the early stages of recovery.  

  How can developing chronic pain be avoided?

The scientific literature suggests that if recovery has not occurred within the first 3 months, there is a high likelihood that the person will continue to have pain a year later.  A portion of those people will gradually improve but not necessarily recover 100%, another portion will remain unchanged, and another portion will become worse.  Surprisingly, as many as 50% of those with a motor vehicle or a work-related injury are at high risk for long term pain.  Even more astounding is that research to date suggests the risk for long term pain appears to be strongly related to how each person responds to the pain experience itself.

For those individuals whose injuries are at risk of lasting more than 3 months, a combination of therapies is best.  This may include relaxation techniques, meditation techniques, even psychological support to address sleep and mood changes that frequently arise as pain persists.  Most important is that the injured person remains active, positive, and engage in daily self-treatment measures.