Detailed 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.

If you would like to receive this document please click here and send an e-mail, stating whether you would prefer to receive an electronic or paper copy, and enclosing relevant information.


General Advice

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.

Musculo-skeletal injury that involves swelling
Injuries with associated muscle spasm
Low Back Pain
The R.I.C.E Regime

Musculo-skeletal 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 R.I.C.E regime.
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Injuries 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.
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Advice for Low Back Pain

80% of working people in the U.K. will experience back pain in their lives, so when it hits...

1. 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.
   
   
2. If you have symptoms that involve bladder or bowel control problems - seek medical advice.
   
   
3. Two days bed rest is the accepted maximum for most back problems, - after this time, start to mobilise within your tolerances of pain.
   
   
4. 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).
   
   
5. 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.
   
   
6. 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.
   
   
7. Icing is an underestimated reliever of low back pain

The R.I.C.E Regime.

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 un-injured parts.

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 swelling.

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 upsets.

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
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