Advice on Pain
Pain is probably
the single main reason for a client to present to a physiotherapist
and for this reason Physioworks commissioned one of their staff
Paul Browning MSc MCSP SRP, to write an in-depth overview of 'Pain.'
This explains topics such as inflammation, ischaemic pain, mechanical
pain, neural pain (both peripheral and central) and there is a large
section on movement - its dysfunction and how this can cause pain.
This has been written in detail and is for those who trawl the web
in search of help for their own conditions.
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Physioworks advises you to see a competent Physiotherapist or Doctor. This information should not be construed to be appropriate for every case and is a general indicator as to current understanding of best practice, nothing else.
injury that involves swelling
Injuries with associated muscle spasm
Low Back Pain
The R.I.C.E Regime
injury that involves swelling
Any musculo-skeletal injury that involves swelling, however minor,
and has an onset which can be described with words such as a: pull,
twist, sprain, strain, knock or similar, is best treated by the
with associated muscle spasm
Injuries with associated muscle spasm, especially spinal conditions
can also benefit from by the R.I.C.E regime. Cuts,
abrasions and burns should be treated by other first aid measures
not described here.
for Low Back Pain
80% of working people in the U.K. will experience back pain in their
lives, so when it hits...
- Don't have a long hot bath. The curved shape of the bath will
aggravate a back problem that is made worse by sitting or lifting.
The heat will increase swelling.
- If you have symptoms that involve bladder or bowel control problems
- seek medical advice.
- Two days bed rest is the accepted maximum for most back problems,
- after this time, start to mobilise within your tolerances of
- During the day lie on your back with your knees up and your
feet flat on the floor. This is a low strain position for your
back called 'crook lying'. Add very gentle leg rolls (taking both
knees to either side gently, within limits of pain).
- For low back pain with sciatica (referred pain down the leg
from the back) from a crook lying position get someone gently
using their body weight, to pull behind the knees to traction
the low back.
- McKenzie extensions are also worth trying for disc related low
back pain. Lie on your stomach and do a half push up leaving your
hips on the ground. Stay within the limits of pain.
- Icing is an underestimated reliever of low back pain
R is for Rest.
Stop what you are doing. Running around increases your heart's output
and blood supply to all the body including the injured part and
so will increase both the swelling and recovery time. 'Relative
rest' describes the resting of an injured part while using or exercising
I is for Icing.
15 minutes of ice, (wrapped in a damp cloth to minimise the risk
of an ice burn) applied to the injury on a regular basis (3 or 4
times a day) reduces swelling, pain, and healing time.
C is for Compression.
A relatively tight compression of the injured area helps to reduce
E is for Elevation.
If possible lift and support the injured limb so that gravity can
help track the swelling back towards the heart.
Anti-inflammatories such as ibuprofen (which is the drug in nurofen),
can help speed recovery. The effects may not be as instant as one
hopes - if there is significant swelling they may be cumulative.
Please read the instruction which come in the packet - this is especially
important if you are pregnant, have asthma or are prone to stomach
Diagnosis It is important that if things don't settle that you get
a diagnosis. As some medical conditions masquerade as musculo-skeletal
problems, or if you want an insurance company to pay for treatment,
a GP's appointment should be your first contact, however, you can
'self-refer' to a private physiotherapist.
An initial appointment should give you a diagnosis and suggest strategies
that you should employ to help reduce the problem and its effects