Pain can mean different things to different people. A person’s relationship to pain is very subjective and can take many shapes and forms. Some people may mistake muscle soreness as pain while other people only feel pain when the sensation of pain is severe or acute. There is no right or wrong and however, the signal of pain or discomfort is received it should be recognized and addressed.
It may not seem like it, but pain is a crucial tool for human survival. I like to say that “pain is our friend” and would like to explain why. Certain signals travel from our body sensory receptors to the processing center of our brain and all of these signals are important in maintaining health. For example, if we touch something hot or sharp, a signal is sent to the brain and the brain signals to move that part of our body away from the noxious stimulus (sharp object). Our body sends a signal to the brain when we are cold or hot and that something needs to be done to maintain our body temp. In particular, in situations where there is damage to a joint or other soft tissue, a signal is sent to the brain saying, “Hey! You need to pay attention to this area because something is wrong.” Our response to this signal or message is where the waters get muddy.
We live in a society where we have been conditioned that pain is fixed by medication. I get a headache, take two aspirin, and the pain goes away. My back is hurting, take pain medication and the pain goes away.
This is great for a short-term fix, but what is happening here? Does the pain-reducing mean that the problem is being fixed? Do the pain medications address the issue of damage or dysfunction? The answer is, no. Put simply, pain medication blocks the signal that the body is sending to the brain, so basically, the body is still yelling at the brain to “figure out” how to fix the problem, but the brain cannot hear the signal anymore. That is, at least until the pain medication wears off.
There are many problems with this system of medicating the symptom and overlooking the actual cause. Here's a few:
The issue or dysfunction is not being corrected and will continue to get worse because we are not changing the patterns of behavior that led to the situation to begin with.
Once we get the pain meds on board, we “feel better” and we go on about our usual activities which can further damage the area of concern, compounding the problem.
Pain medications prescribed are opioids, which are highly addictive and damaging to our gut. I could write many pages on the gut and systemic inflammation and how this directly relates to pain and discomfort in the entire body. In one article, in particular, Hamid I. Akbarali and William L. Dewey discuss how chronic opioid treatment reduces gastrointestinal transit resulting in an altered microbiome and increased systemic inflammation.2
Injections: Some medications that are injected into the area of pain can lead to degeneration of the surrounding soft tissue, including the cartilage that pads the joints, tendons, and ligaments. In an article by Hauser, MD he states that traditional pharmacological treatments, including nonsteroidal anti-inflammatory drugs and corticosteroids shots, are typically used to not only decrease symptoms but also to hopefully improve the physiology of the disease process. Unfortunately, the preponderance of the evidence shows that these treatments accelerate the osteoarthritic process.1
What is concerning as a clinician is how readily pain medications are prescribed and the prevalence of people using these medications for long-term management of pain. At WAV PT, we practice a variety of ways to reduce pain to facilitate the return to a more normal function. Some of these approaches include specific breathing techniques coupled with gentle movements that stimulate the calming area of the nervous system. Gentle Manual Therapy techniques help to release trigger points and other painful restrictions in the joints and tissues. Reiki has been shown to reduce pain as well as stress and anxiety and is widely used in hospitals around the world. We have an infrared sauna that is very effective in reducing pain and inflammation. We offer options for natural CBD tinctures and topical creams to help reduce pain and inflammation when needed. There are many other alternatives available too such as acupuncture which has proven very effective in natural pain relief. While these alternatives are not always effective in all ways for every person, we strongly feel that these types of interventions will help and should be exhausted first before turning to pharmaceutical pain medications.
Are we completely against pain medication? Not necessarily. There are times where pain medication can help during the rehab process. When pain is severe, it is difficult to tolerate any kind of movement or manual therapy that may be needed to correct the issue or dysfunction. This is especially true post-surgery. There are times where I will tell people to take their pain meds an hour or so before coming into the clinic so they can tolerate therapy, which has to be done to maximize a successful recovery.
Pain medication can be used as a tool but would be just one small part of your healing process. They should be used sparingly and with the intent that it will assist you in figuring out how to correct dysfunction, heal, and continue a maintenance plan that will prevent future issues.
Listen to your body. When it is sending a signal, do not ignore or mask it. If you are having pain, let’s together figure out the root cause and come up with a plan to correct and maintain optimal function, getting past the pattern of pain and discomfort for good. The big picture is that pain medication cannot fix the problem and it is not a treatment. It will only mask and in some cases, prolong or worsen the issue and pain.
While it would be nice, there is no magic pill to fix everything. Treatment and prevention are not always quick fixes, especially as we age. So, let's enjoy the ride and get through the bumps that may come up. At WAV PT we are hoping to spread the word that we are here to help and support you along your healing journey, and that maintenance and a healthy, balanced lifestyle can help prevent or lessen any health obstacles that come our way, living full, enriching lives at our personal best. Having the support of a like-minded community can help us all enjoy that journey together.
1. Hauser, Ross A. MD, The Deterioration of Articular Cartilage in Osteoarthritis by Corticosteroid Injections. Journal of Prolotherapy. 2009;1(2):107-123.
2. Akbarali HI, Dewey WL. Gastrointestinal motility, dysbiosis and opioid-induced tolerance: is there a link?. Nat Rev Gastroenterol Hepatol. 2019;16(6):323-324. doi:10.1038/s41575-019-0150-x