Treatments

Chronic Pain Treatments

With chronic pain, signals of pain remain active in the nervous system for weeks, months, or even years. This can take both a physical and emotional toll on a person. The most common sources of pain stem from headaches, joint pain, pain from injury, and backaches. Other kinds of chronic pain include tendinitis, sinus pain, carpal tunnel syndrome, and pain affecting specific parts of the body, such as the shoulders, pelvis, and neck. Generalized muscle or nerve pain can also develop into a chronic condition. At Pro Sports Care we can provide effective treatments to ease your chronic pain.

Chronic pain may originate with an initial trauma/injury or infection, or there may be an ongoing cause of pain. However, some people suffer chronic pain in the absence of any past injury or evidence of body damage.

Spinal Problems Treatments

Your backbone, or spine, is made up of 26 bone discs called vertebrae. The vertebrae protect your spinal cord and allow you to stand and bend. A number of problems can change the structure of the spine or damage the vertebrae and surrounding tissue. They include

  • Infections
  • Injuries
  • Tumors
  • Conditions, such as ankylosing spondylitis and scoliosis
  • Bone changes that come with age, such as spinal stenosis and herniated disks

Spinal diseases often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement. Treatments differ by disease, but sometimes they include back braces and surgery.

Postural Strain

Our bodies are designed to move and restricting this innate mechanism leads to mechanical issues such as tightness in our muscles, ligaments and joints. Poor posture in one region of the spine will lead to adaptive patterns in adjacent regions, so that poor upper back (thoracic) posture will often lead to neck pain. Sitting at a desk for long periods is one of the worst postures we can adopt. The body is really not designed to sit – especially when the chairs we think of as comfortable are actually putting strain on our hip joints and allowing us to become ‘soft’ through our core muscles (abdominal and lower back) that can ultimately lead to a loss of the body’s ability to protect itself against movements it was designed for.

The longer we persist in certain postures the more likely our body’s postural system will begin to see it as normal and the longer it might take to unwind.

Sciatica

Sciatica is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body. Pain can be severe in prolonged exposure to cold weather.

Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. This point is important, because treatment for sciatica or sciatic symptoms often differs, depending upon the underlying cause of the symptoms and pain levels.

Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel – a narrow, rigid passageway of ligament and bones at the base of the hand – houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body’s peripheral nerves are compressed or traumatised.

Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to “shake out” the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.

Back Pain

Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.

Back pain may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may radiate into the arms and hands as well as the legs or feet, and may include symptoms other than pain, such as weakness, numbness or tingling.

Back pain is one of humanity’s most frequent complaints. Acute low back pain (also called lumbago) is the fifth most common reason for physician visits. About nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year.

The spine is a complex interconnecting network of nerves, joints, muscles, tendons and ligaments, and all are capable of producing pain. Large nerves that originate in the spine and go to the legs and arms can make pain radiate to the extremities.

Sports Injuries

Exercising is good for you, but sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices or improper gear can cause them. Some people get hurt because they are not in shape. Not warming up or stretching enough can also lead to injuries.

The most common sports injuries are

  • Sprains and strains
  • Knee injuries
  • Swollen muscles
  • Achilles tendon injuries
  • Pain along the shin bone
  • Fractures
  • Dislocations

If you get hurt, stop playing. Continuing to play or exercise can cause more harm. Treatment often begins with the RICE (Rest, Ice, Compression and Elevation) method to relieve pain, reduce swelling and speed healing. Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation and sometimes surgery.

Repetitive Strain Injuries

Repetitive strain injury (RSI) is a syndrome incorporating several discrete conditions associated with activity-related arm pain such as edema, tendinitis, carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, DeQuervain’s syndrome, stenosing tenosynovitis, intersection syndrome, golfer’s elbow or medial epicondylitis, tennis elbow or lateral epicondylitis, reflex sympathetic dystrophy syndrome (RSDS), thoracic outlet syndrome, radial tunnel syndrome, and focal dystonia.

RSI is also used as an umbrella term for non-specific illnesses popularly referred to as Blackberry thumb, iPod finger, gamer’s thumb (a slight swelling of the thumb caused by excessive use of a gamepad), Rubik’s wrist or “cuber’s thumb” (tendinitis, carpal tunnel syndrome, or other ailments associated with repetitive use of a Rubik’s Cube for speedcubing), Trigger finger, Stylus Finger” (swelling of the hand caused by repetitive use of mobile devices and mobile device testing.), Raver’s Wrist, caused by repeated rotation of the hands for many hours (for example while holding glow sticks during a rave), and others.

Doctors have recently begun making a distinction between tendinitis and tendinosis in RSI injuries. There are significant differences in treatment between the two, for instance in the use of anti-inflammatory medicines, but they often present similar symptoms at first glance and so can easily be confused.

The following complaints are typical in patients who might receive a diagnosis of RSI:[2]

  • Short bursts of excruciating pain in the arm, back, shoulders, wrists, hands, or thumbs (typically diffuse – i.e. spread over many areas).
  • The pain is worse with activity.
  • Weakness, lack of endurance.

Foot / Ankle Problems

Your feet are perhaps one of the most complex parts of your body. They work incredibly hard, in most cases without much attention being paid to them until something goes wrong.  Feet provide support to the entire body to enable us to walk. Each foot is made up of 52 bones, 66 joints, 19 muscles and a system of more than 100 tendons, ligaments, muscles, blood vessels and nerves.

On average, a person’s feet will carry them on a journey of approximately 128,000 kilometers in a lifetime – the equivalent of a journey three times around the world.

Our feet absorb nearly two times our body weight during normal walking and up to four times our body weight when we are jogging.  So, given the pressure we put on our feet, it’s not surprising that sometimes medical problems arise.

Shoulder and Elbow Conditions

Shoulder

The shoulder is the most mobile joint in the human body, capable of a nearly 360 degree range of motion. However, the complex mechanics of the shoulder make it vulnerable to injury. According to the American Academy of Orthopaedic Surgeons, an estimated 4 million people seek medical assistance for shoulder and upper arm strains and sprains each year.

Shoulder injuries, which affect people of all ages, can be caused by sports activities that involve overhead motion like swimming, tennis, pitching and weightlifting. People who do repetitive overhead movements in everyday life like painting, construction, and gardening are also susceptible to shoulder conditions ranging from sprains, strains and arthritis to tendonitis, bursitis, frozen shoulder and torn rotator cuffs.

The shoulder joint is made up of the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper-arm bone). The shoulder joint, or glenohumeral joint, is a ball-and-socket joint that helps the shoulder move forward and backward and makes it possible for the arm to move in a circular motion and lift away from the body.

Elbow

The elbow joint links the upper arm bone (humerus) and the two bones of the lower arm (ulna and radius). The elbow joint operates like a door swinging on a hinge and also performs twisting and rotating motions. The elbow is also made up of muscles, nerves and tendons that connect the tissues between muscles and bones.

 

Wrist and Hand Conditions

Wrist and hand pain are extremely common complaints, and there are many common causes that we see almost every day in practice. It is important to have a professional assessment to accurately diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause.

Injury to the sensitive structures of the wrist and hand, or inflammatory conditions such as bursitis or tendonitis often respond well to conservative physical therapy. Conversely if left untreated, may require more invasive medical treatments such as injections or even surgery. The following is a partial list of conditions that we treat successfully at our office:
  • Tendonitis
    A tendon is a fibrous band that attaches muscle to pain. If irritated, the tendon can become inflamed and is termed “tendonitis”. We commonly see tendonitis in practice. Tendonitis can cause wrist pain and swelling. The inflamed tendon creates pain with most every movement of the hand, fingers, wrist and forearm. Additionally, the inflammation may create pressure on other sensitive structures, such as nerves, in the area. As a result of the pain, patients often immobilize the joints. Prolonged immobilization (greater than 48-72 hours), couple with pressure on sensitive structures can lead to more serious problems, that are often difficult to correct conservatively.
    If you believe that you may be suffering from tendonitis – don’t delay. Consult a trained professional today.

 

  • Sprain
    Wrist sprains are another common injury that we see regularly. Ligaments are strong, inelastic bands that connect bone to bone. Injury to a ligament is called a “sprain”. Sprains can cause problems by limiting the use of our hands. As in the case with sprains, you will have an inflammatory response, just as with any other tissue injury. Prolonged immobilization, and inflammation can be very dangerous. Severe cases of ligament injury can necessitate surgery, but can easily be determined by most physical therapy evaluations, without the necessity for advanced diagnostic imaging.

Rehabilitation Programs

Rehabilitation programs follow specific post-surgical rehabilitation protocols focusing on individualized treatment interventions with the goal of therapy of returning the patient to optimal strength, function and mobility.

The programs involve a variety of treatment options with goals set for the patient to resume normal activities of living as much as possible. Goals are established by a physical therapist and/or an occupational therapist and the patient after a thorough evaluation.

Our highly skilled staff have been trained and educated to work with a variety of post-operative procedures:

– Total Joint Replacements
– Ligament and Tendon Repairs
– ORIF/OREF Implants
– Amputations
– Nerve Compression Release
– Tendon Transfers
– Joint Fusion

Neck Pain and Stiffness

A stiff neck is typically characterized by soreness and difficulty moving the neck – especially when trying to turn the head to the side. A stiff neck may also be accompanied by a headache, shoulder pain and/or arm pain, and cause the individual to turn the entire body as opposed to the neck when trying to look sideways or backwards.

Symptoms typically last for a couple of days or a week and may prompt neck pain that ranges from mildly painful but annoying to extremely painful and limiting. While there are a few instances in which neck stiffness is a sign of a serious medical condition, most episodes of acute neck stiffness or pain heal quickly due to the durable and recuperative nature of the cervical spine.

The most common causes of a stiff neck include, but are not limited to, the following:

Muscle Strain or Sprain
By far the most common cause of a stiff neck is a muscle sprain or muscle strain, particularly to the levator scapula muscle. Located at the back and side of the neck, the levator scapula muscle connects the cervical spine (the neck) with the shoulder. This muscle is controlled by the third and fourth cervical nerves (C3, C4).

Meningitis / Infection
A stiff neck, in conjunction with a high fever, headache, nausea or vomiting, sleepiness and other symptoms, may be indicative of meningitis, a bacterial inflection that causes the protective membranes of the brain and spinal cord to be inflamed. Other infections can also cause stiff neck symptoms, such as meningococcal disease, an infection in the cervical spine. Any time a stiff neck is accompanied by a fever it is advisable to seek immediate medical attention to check for these possibilities.

Cervical Spine Disorders
Many problems in the cervical spine can lead to neck stiffness. The stiffness can result as a reaction to the underlying disorder in the cervical spine. For example, a cervical herniated disc or cervical osteoarthritis can lead to neck stiffness, as the structures and nerve pathways in the cervical spine are all interconnected and a problem in any one area can lead to muscle spasm and/or muscle stiffness.