Musculoskeletal Pain Syndrome Archives

How 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…

Escaping 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…

Downsides 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…

Falling 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…

Movement-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…

Right 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…

Exercise 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…

Adding 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…