April 25th, 2024
Integrating Pain Science and the McKenzie Method
Recently I had a patient come in with chronic back pain and hip pain that eventually got to a level that injections and chiropractic treatment was no longer effectively managing. Note, she had been using these strategies for at least a decade to try to manage her pain. She was experiencing severe pain to the level she was unable to participate in her volunteer work, walk for exercise, take care of her home, or perform normal activities without needing to sit down due to back and hip pain. We had successfully helped her rehab back to normal function from a couple of surgeries and 1 non-operative extremity injury. She was later recommended PT by her physician when other methods of management were not reducing her symptoms.
We took this patient through a thorough assessment and found that use of the extension principle could rapidly turn off her pain. Over a handful of visits, she returned to the ability to do normal volunteer work, perform many of her normal household chores and walk within her home and short distances in the community. While she was a lot better, she was still having trouble with progressing into longer duration activities, and back into some activities she had gradually reduced over the years while trying to manage the pain in other ways. She found that back or hip pain would set in during her therapy exercises or during normal activities that would be intense but that would rapidly subside.
We analyzed when this pain would happen, what activities and movements caused it to come on, and how it would subside. The findings: Much of this pain was muscular in nature but was in the same region her back pain would refer to. We explained to her that the pain she was experiencing was real and that because she had been experiencing pain in this region so often her body had difficulty differentiating muscle fatigue/ “I need a break” discomfort from the true mechanical pain referred from her back.
We discussed how that with gradual graded use of those muscles and graded exposure to some of these activities that can generate this muscular pain we could help the body begin to differentiate the mechanical pain from her back vs the muscular discomfort she had become overly sensitized to. We showed her how to effectively differentiate between mechanical pain vs muscular pain. All while encouraging her to have a positive and minimally painful experience with movement.
The outcome is a successful return to prolonged leisure walks, progression to functional movement patterns such as squats, hinges, carries, etc... with minimal back and hip pain.
If you have suffered for a long or short period of time with any pain or issue, please contact us today to discuss what ProMotion Rehab and Sports Medicine can do to help you Move Better, Live Better and Play Better!
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