By: Jerry Moczerniuk PT, DPT
Pain is not a normal sensation in our body. It is after all a communication tool, triggered by our nervous system, which provides us with information that there may be an injury somewhere within us. Most people experience pain in thier lives, and pain can be a great diagnostic tool in helping us accurately assess the reason for the pain.
Pain is an uncomfortable feeling, both sensory and emotional. It can be sharp, dull, steady, throbbing, aching, or may even be described in many other ways. Pain can simply be a nuisance, like a mild throbbing from a bee sting. Other times it can be absolutely debilitating and may significantly impact all aspects of a person’s life, including their job, daily activities and relationships. Pain can be secondary to trauma, burns, overuse tissue damage, neuropathy, but can also be a symptom of ongoing systemic disease.
In medicine pain is classified as either acute or chronic. Acute pain typically comes on suddenly, is severe and short-lived, often caused by an injury to soft tissue (muscle, tendon, skin, organs), or bone. Chronic pain on the other hand is present for extended periods of time, sometimes years, and may even last for life. In America more than 100 million people live with chronic pain. Chronic pain can be the result of damaged tissue initially, but very often is attributable to nerve damage and may require constant ongoing treatment. Acute pain may in fact lead to chronic pain if not treated in a timely fashion. Under normal circumstances, pain stimuli diminish as healing process progresses and pain sensation lessens, until minimal or no pain is detected. If normal tissue healing process is interrupted or impaired however, pain may become chronic.
Pain is ultimately considered a symptom, and it should be accurately assessed in order to be properly treated. Treating pain itself may not address the root cause of pain. Pain medications can diminish pain, epidural injections may reduce swelling and pain from nerve compression, but the underlying reason for pain is likely to persist.
The topic of treating pain has been a hot topic over the last 5 years, sparked by an emerging National opioid overdose epidemic. According to 2014 statistics drug overdose is the leading cause of accidental death in the U.S., driven in majority by 18,893 (in 2014) overdose deaths related to prescription pain relievers.
In March of 2016, the CDC released prescription opioid guidelines stating that prescription opioids are appropriate in certain cases, including cancer treatment, pallative care, and end of life care, and in certain acute situations, dosed appropriately. The CDC also recommended for other pain management, non-opioid approaches such as Physical Therapy should may be more appropriate.
Treatment for pain therefore should be multi disciplinary, and include Physical Therapy. A Physical Therapist should be considered a great initial option for evaluation and treatment of acute and chronic pain. Not all pain is treatable with Physical Therapy, but a skilled Physical Therapist should be able to determine the cause of your pain, and make appropriate referral/recommendation based on evaluation findings. Addressing acute pain early may reduce the prevalence of that pain becoming chronic. Remember, in New Jersey you can be evaluated and treated by a Physical Therapist without a referral from your doctor.
Dr. Moczerniuk is a Doctor of Physical Therapy, member of American Physical Therapy Association, and a Clinical Director at db Orthopedic Physical Therapy of Manalapan LLC, located at 120 Craig Rd. Suite 2. Dr. Moczerniuk can be reached at 732-462-2162 or via e-mail at Jerry@dborthopt.com. You can also find out more about our practice at dborthopt.com
