After an accident, your pain gives a lot of clues about the treatment you need.
by John V. Murphy
When seeking help after an accident, did your doctor or therapist ask you if the pain was immediate or if the pain came about hours or days later? The behavior of the onset of pain is often a main determinant in what treatment is the best approach to correct the problem.
Different treatment approaches work for different problems. It is important that the doctor or therapist has many treatment options available to them and picks the right one for each situation. The behavior of the pain is a huge indicator for which treatment will provide curative results.
What does it mean if the pain is immediate? If the pain is immediate it means that you have received a “structural trauma.” Worst case is that you fractured something.
In this instance, your doctor will recommend a cast or surgery to repair the fracture. There will be a period of immobilization followed by rehabilitation by reintroducing normal movement as you heal. For this type of problem, a surgeon would provide you with the best success.
The other type of structural trauma is a subluxation. In a subluxation, a joint is shifted out of its normal position and is unable to return back. It’s like a screen door being knocked out of position. It needs to be put back. For these types of problems a chiropractor or physical therapist who practices a similar type of manual therapy would provide you with the best odds for success.
What if the pain has a delayed onset? If the pain has a delayed onset, we know that you do not have a structural trauma. Results from X-rays will be negative and MRIs will also be negative or the information will be some variation of normal and is not a result of the accident. Delayed onset pain is the result of “neuromuscular trauma.” This means that the communication between the brain, nerve and muscle has become altered and doesn’t know how hard to pull or when to relax. The result is a feeling of pain and tightness since the body is being held in awkward positions. Treating this problem in the same way you treat a structural trauma will only provide short term results, usually for minutes or hours. A manual therapist, usually a specialized physical therapist or massage therapist, who understands any of the hundreds of neuromuscular interventions (the most famous being myofascial release and strain counter strain) will be able to reset the proper relationship between the nervous system and the muscle and provide the patient with curative results.
What if you have both structural and neuromuscular trauma from an accident?
The truth is you most likely do have both types of trauma and that is why it is important for health professionals to be educated in many styles of care. When a patient has a multitude of injuries of different types the only practical way to win is to recognize the location and type of each injury and properly address all of them in the correct way so that the body can achieve enough normalcy to return to health again. At Core Physical Therapy our priority is to treat the whole patient in the correct way. Every patient is different and the program evolves as the patient improves.
Next Steps? If you are not benefitting or only partially benefitting from the therapy or care you are receiving, then come to Core for a second opinion. More information is always a good idea. It cannot hurt and will likely be the game changer you have been hoping for. If you live further away, schedule a telehealth appointment so that we can help you find the right people to give you progressive benefit in your area.