Pain Archives - Damien Howell PT

Pain – Movement

If pain occurs with movement, then observation and analysis of movement is required. The measurement of the symptom of pain occurs using the familiar numeric pain scale (zero to 10). 0-10 Numeric pain scale diagram. Clipart image In 1996 the American Pain Society lead a campaign to consider the measurement of pain as the 5th…

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…

Gait Deviations Musculoskeletal Pain Syndromes: Is there a gait deviation or cluster of gait deviations which is common across musculoskeletal pain syndromes?

Gait deviations are considered risk factors and/or causative drivers for musculoskeletal pain syndromes. There is a growing body of research showing a relationship between gait deviations and musculoskeletal pain syndromes injuries: shin pain (here, & here,) ; patella-femoral arthralgia (here); IT band syndrome; Achilles pain; plantar heel pain (here, & here). There is growing consensus…

Physical Therapy Telehealth: It works well for some, not for others

The COVID 19 pandemic crisis has many challenges for the standard everyday health care and medicine. The pandemic resulted in a sudden increase of telehealth services. There are reports there has been an 18% increase in the number of healthcare providers providing telehealth services in response because of the pandemic. Healthcare providers and patients are…

Low-Tech Slow-Motion Analysis – “Dance Step to Nowhere

NDeviant movement during walking contributes to the development of or compensation for musculoskeletal pain syndromes. Diagnosis and treatment occur with visual observation and analysis of gait. The use of a smartphone video facilitates the analysis of motion walking. However, there are times when less technological motion analysis is necessary. When dealing with painful musculoskeletal syndromes…

Symptom modification of painful gait

Symptom modification procedure is common practice in the Physical Therapy profession. This procedure involves identifying the specific movement, posture, and/or activity that reproduces the patient’s symptoms. Historically diagnosis of musculoskeletal problems was based on examination which selectively provoked musculoskeletal tissues by compressing or stretching the various tissues to provoke the symptoms. This provided direction for…

Pain walking/running deviant gait – self treat &/or seek expert assistance

Experiencing pain when walking or running can be a complex problem. Asserting a hypothesis is a systematic way to solve complex problems. A hypothesis is an “if-then statement” or conditional statement which can be tested, accepted, or refuted. Hypothesis: If you have pain walking and/or running, then gait analysis to determine if there is a…

As a patient, how do I get my healthcare provider more engaged in my care plan?

The goal of any relationship between a healthcare provider and patient is that both parties feel they are invested in favorable health outcomes. How they get there is the question. The underlying assumption is that a high degree of engagement from the provider and the patient will result in better outcomes, costs less, and may…

How to exercise to lose weight when exercise is painful

High body mass index (BMI) is significant factor in low back pain, osteoarthritis; hip osteoarthritis; knee osteoarthritis, plantar heel pain. Weight loss intervention for pain reduction Decreasing body weight is an effective intervention to decrease musculoskeletal pain. Research by Stephen Messier at Wake Forest U, looking at individuals with painful osteoarthritis of the knee who…

Deviant Gait – Compensation

Compensation is necessary when there is injury or a necessity of making up for something unwelcome or unpleasant. Compensation can be perceived as a negative or positive situation. With injury the dichotomy is will there be recovery or compensation? Salamanders are fascinating animals that are capable of regenerating lost limbs, as well as other…