Posts Tagged ‘Musculoskeletal Pain Syndrome’
Pain Severity vs Pain Irritability: Why the difference matters in musculoskeletal care
A recent patient with shoulder pain persuaded me that pain intensity does not always reflect the clinical seriousness of a condition. Pain irritability – how easily pain is triggered and how long it lasts – often matters more for guiding treatment decisions. A 65-year-old male reported right shoulder pain. When queried, when did it start…
Read MoreHow to mitigate risks & enhance benefits of DIY care of non-traumatic musculoskeletal pain
My January 2026 visit to my healthcare provider was shocking: my coinsurance deductible is twice as much as last year. My health insurance company increased my premium by 25%. Around the same time, I am doing a “do-it-yourself” repair of my Wi-Fi system. My Physical Therapy practice is a one-man shop. So, one of my…
Read MoreHow Horizontal Body Proportions “Inverted Triangle” Can Relate to Back Pain
A current patient with recalcitrant back pain is challenging me to look for innovative strategies for treatment. This 29-year-old male has a 3-year history of low back pain. The pain occurs daily, with an average intensity of 3 out of 10. The symptoms are worse with prolonged sitting. Worse on days that he is more…
Read MoreEscaping the Drama Triangle: Practical Tactics for Direct Dialogue Between Physical Therapists & Surgeons.
Earlier in my Physical Therapy career, I joined a pain management team at a teaching hospital. Team members included an Anesthesiologist, Primary Care Provider, Physical Therapist, Psychologist, and others. We held team meetings to discuss chronic pain patients. Few would dispute that face-to-face real-time communication was a particularly effective way to provide care. Unfortunately, the…
Read MoreDownsides of steroid injections for hip pain – What 3 patients taught me
Three patients with chronic hip pain prompted me to dive deeper into the effectiveness and risks of the common intervention of corticosteroid injection for musculoskeletal pain syndromes. Patient A complains of difficulty lifting his leg to put his pants on when standing and difficulty lifting his leg to transfer into his car. He had a…
Read MoreFalling Off the Wagon Isn’t the End: Learning from Lapses in Exercise & Recovery
During a routine follow-up, my patient “Larry Lapes,” who has chronic ankle and back pain, asked me a question that stopped me in my tracks: “Do you have any strategies that help your patients stick to their exercise routines?” His question prompted me to reflect more deeply on lapses and relapses in behavior change. Behavioral…
Read MoreMovement-evoked pain measurement for adjustment of interventions for chronic musculoskeletal pain syndromes
If chronic musculoskeletal pain syndrome is like diabetes, then what is a self-administered test to adjust interventions? A thought-provoking article by Jermey Lewis and Peter O’Sullivan suggests “Is it time to reframe how we care for people with non-traumatic musculoskeletal pain” they suggest we have a lot to learn from how other chronic medical and…
Read MoreRight person – Choosing a healthcare provider to address chronic musculoskeletal pain syndromes
When dealing with musculoskeletal pain syndrome the ageless advice is the best solution is to see the right person, for the right care. For chronic and/or recurring musculoskeletal pain syndromes the choice of the healthcare provider assumes more importance. As it is likely to be a long-lasting relationship. You can choose from several different types…
Read MoreExercise prescription – Art & Science
Exercise while not a drug can behave like one. Exercise can help in the management of chronic diseases and offer pain relief for individuals suffering from musculoskeletal pain syndromes. Like prescribing drugs, the concept of dosage applies to exercise prescription. A dose-response to exercise is not unlike drugs however the minimum dose, dose-response, and maximum…
Read MoreAdding observation of deceleration forces to diagnosis & treatment of movement system impairment syndromes & musculoskeletal pain syndromes
Shirley Sahrmann and colleagues share an elegant clinical reasoning process model to diagnose and treat musculoskeletal pain syndromes and movement system problems. The movement system is physiological organ systems that interact to produce movement of the body and its parts. The basis is alignment in a deviant position and repeated deviant movements in a…
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