Blue Ridge

Sprains, Strains, Breaks: What’s the Difference?

If you’ve sprained your ankle, you know what severe pain is.

But maybe that “sprain” was a “strain” or possibly even a “break.”

The amount of pain in each case can be virtually equal, so oftentimes the only way to find out what you have is to see a doctor.

Just the facts
Here are some facts on musculoskeletal injuries:

  • Sprains are a stretch and/or tear of a ligament, the tissue connecting two bones. Ligaments stabilize and support the body’s joints. For example, ligaments in the knee connect the upper leg with the lower leg, enabling people to walk and run.
  • Strains are a twist, pull and/or tear of a muscle and/or tendon. Tendons are cords of tissue that connect muscles to bones.
  • Breaks are a fracture, splinter or complete break in bone, often caused by accidents, sports injuries or bone weakness.

Health care providers attend to millions of Americans with musculoskeletal injuries each year, according to the United States Bone and Joint Decade (USBJD). The USBJD says that about 18.4 million sprains and strains were treated in 2007. And about 16.2 million fractures were treated.

Sprains
A sprain is caused by trauma — a fall, twist, or blow to the body, for example — that applies stress to a joint and overstretches or even ruptures supporting ligaments.

In a mild sprain, a ligament is stretched, but the joint remains stable and is not loosened. A moderate sprain partially tears the ligament, causing the joint to be unstable. With a severe sprain, ligaments tear completely or separate from the bone. This loosening interferes with how the joint functions. You may feel a tear or pop in the joint. Although the intensity varies, all sprains commonly cause pain, swelling, bruising, and inflammation.

The ankle is the most commonly sprained joint. And a sprained ankle is more likely if you’ve had a previous sprain there. Repeated sprains can lead to ankle arthritis, a loose ankle or tendon injury.

Strains
Acute strains are caused by stretching or pulling a muscle or tendon. Chronic strains are the result of overuse of muscles and tendons, through prolonged, repetitive movement. Inadequate rest during intense training can cause a strain.

Typical symptoms of strain include pain, muscle spasm, muscle weakness, swelling, inflammation and cramping. In severe strains, the muscle and/or tendon is partially or completely ruptured, resulting in serious injury. Some muscle function will be lost with a moderate strain, in which the muscle/tendon is overstretched and slightly torn. With a mild strain, the muscle or tendon is stretched or pulled, slightly.

These are some common strains:

  • Back strain. When the muscles that support the spine are twisted, pulled or torn. Athletes who engage in excessive jumping — during basketball or volleyball, for example — are vulnerable to this injury.
  • Hamstring muscle strain. A tear or stretch of a major muscle in the back of the thigh. The injury can sideline a person for up to 6 months. The likely cause is muscle strength imbalance between the hamstrings and the quadriceps, the muscles in the front of the thigh. Kicking a football, running or leaping to make a basket can pull a hamstring. Hamstring injuries tend to recur.

Breaks
Bone breaks, unlike sprains and strains, should always be looked at by a health care provider to ensure proper healing. Call your provider if the pain does not subside or if the bone appears to be deformed. Seek urgent medical care if you have numbness, weakness, or poor circulation in the injured limb.

Athletes are most susceptible
All sports and exercises, even walking, carry a risk of sprains. The areas of the body most at risk for a sprain depend on the specific activities involved. For example, basketball, volleyball, soccer and other jumping sports share a risk for foot, leg and ankle sprains.

Soccer, football, hockey, boxing, wrestling and other contact sports put athletes at risk for strains. So do sports that feature quick starts, such as hurdling, long jump and running races. Gymnastics, tennis, rowing, golf and other sports that require extensive gripping put participants at higher risk for hand strains. Elbow strains frequently occur in racquet, throwing and contact sports.

Treating injuries
A severe sprain or strain may require surgery or immobilization, followed by physical therapy. Mild sprains and strains may require rehabilitation exercises and a change in activity during recovery.

In all but mild cases, your health care provider should evaluate the injury and establish a treatment and rehabilitation plan.

Meanwhile, rest, ice, compression and elevation (called RICE) usually will help minimize damage caused by sprains and strains. You should start RICE immediately after the injury.

RICE relieves pain, limits swelling and speeds healing, and it is often the best treatment for soft-tissue injuries, such as sprains and strains. Here’s what to do:

  • Rest. The injured area should be moved as little as possible to allow healing to begin.
  • Ice. Apply it immediately to reduce inflammation, which causes more pain and slows healing. Cover the injured area with an ice pack wrapped in a towel for about 15 to 20 minutes, 3 to 4 times a day.
  • Compression. Using a pressure bandage helps to prevent or reduce swelling. Use an elastic bandage. Wrap the injured area without making it so tight that it will cut off the blood supply.
  • Elevation. Raise the injured area above the level of the heart. Prop up a leg or arm while resting it. You may need to lie down to get your leg above your heart level.

Do all 4 parts of the RICE treatment at the same time. If you suspect a more serious injury, such as a broken bone, call your health care provider immediately.

Prevention
No one is immune to sprains and strains, but here are some tips to help reduce your risk for injury:

  • Take part in a conditioning program to build muscle strength.
  • Do stretching exercises every day.
  • Always wear shoes that fit properly.
  • Nourish your muscles by eating a well-balanced diet.
  • Warm up before any sports activity, including practice, and use or wear protective equipment that’s right for that sport.

 

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Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.

 

Online Medical Reviewer: Finke, Amy, RN, BSN
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
© 2000-2014 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

 

 

When Bone Spurs Attack!

Written by John H. Schneider, MD
Spine-Health.com

Bone Spurs (Osteophytes) and Back Pain
Many patients are told that they have bone spurs in their back or neck, with the implication that the bone spurs are the cause of their back pain. However, bone spurs in and of themselves are simply an indication that there is degeneration of the spine; the presence of bone spurs does not necessarily mean that they are the actual cause of the patient’s back pain.

The term “bone spurs” is really a bit of a misnomer, as the word “spurs” implies that these bony growths are spurring or poking some part of the spinal anatomy and causing pain. However, contrary to this implication, bone spurs are in fact smooth structures that form over a prolonged period of time.

The medical term for bone spurs is osteophytes, and they represent an enlargement of the normal bony structure. Basically, osteophytes are a radiographic marker of spinal degeneration (aging), which means that they show up on X-rays or MRI scans and are by and large a normal finding as we age. Over the age of 60, bone spurs on the spine are actually quite common.


Bone Spurs and Spinal Anatomy
The human spine is made of thirty-two separate vertebral segments that are separated by intervertebral discs made of collagen and ligaments. These discs are shock absorbers and allow a limited degree of flexibility and motion at each spinal segment. The cumulative effect allows a full range of movement around the axis of the spine, especially the neck (cervical spine) and lower back (lumbar spine).

Motion between each segment is limited by the tough outer disc ligaments and the joints that move (articulate) at each spinal level (the facet joint). Under each joint, just behind the disc, is a pair of nerve roots that exit the spinal canal. The exiting hole (foramina) that surrounds the nerve (disc in front, joints above and below) is relatively small and has little room for anything besides the exiting nerve.

Normal life stressors, possibly compounded by traumatic injuries to the spinal architecture, cause degeneration in the discs and the joints of the spine. With factors such as age, injury, and poor posture, there is cumulative damage to the bone or joints of the spine. For example:

  1. As disc material slowly wears out, ligaments loosen and excess motion occurs at the joint
  2. The body naturally and necessarily thickens the ligaments that hold the bones together
  3. Over time, the thick ligaments tend to calcify, resulting in flecks of bone or bone spur formation
  4. As the central spinal canal and the foramina thicken their ligaments, compression of the nervous system causes clinical symptoms.

Degenerative changes to normal vital tissue begin in early adulthood, but usually this slow process does not present with nervous system compression until we are in our sixth or seventh decades. Factors that can accelerate the degenerative process and bone spur growth in the spine include:

  • Congenital or heredity
  • Nutrition
  • Life-style, including poor posture and poor ergonomics
  • Traumatic forces, especially sports related injuries and motor vehicle accidents.

As always, to help avoid or minimize back pain it is generally advisable to stay well conditioned (both in terms of aerobics and strength) and to maintain good posture throughout one’s life.

 

BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office
radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.

Your mom knew what she was talking about!

Your mom was always telling you to sit up straight or stand up straight and to put those shoulders back. You may have laughed it off, but now you know she was just looking out for you. Such a simple thing can lead to less pain in the future.

Good Posture Helps Reduce Back Pain

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Written by John Schubbe, DC
www.spine-health.com

Correct posture is a simple but very important way to keep the many intricate structures in the back and spine healthy. It is much more than cosmetic – good posture and back support are critical to reducing the incidence and levels of back pain and neck pain. Back support is especially important for patients who spend many hours sitting in an office chair or standing throughout the day.

Problems Caused by Poor Back Support and Posture

Not maintaining good posture and adequate back support can add strain to muscles and put stress on the spine. Over time, the stress of poor posture can change the anatomical characteristics of the spine, leading to the possibility of constricted blood vessels and nerves, as well as problems with muscles, discs, and joints. All of these can be major contributors to back and neck pain, as well as headaches, fatigue, and possibly even concerns with major organs and breathing.

 

Identifying Good Posture

Basically, having correct posture means keeping each part of the body in alignment with the neighboring parts. Proper posture keeps all parts balanced and supported. With appropriate posture (when standing) it should be possible to draw a straight line from the earlobe, through the shoulder, hip, knee, and into the middle of the ankle.

Because people find themselves in several positions throughout the day (sitting, standing, bending, stooping, and lying down) it’s important to learn how to attain and keep correct posture in each position for good back support, which will result in less back pain. When moving from one position to another, the ideal situation is that one’s posture is adjusted smoothly and fluidly. After initial correction of bad posture habits, these movements tend to become automatic and require very little effort to maintain.

Office work often results in poor posture and strain to the lower back. Many people work sitting in an office chair that is not properly fitted to their body and does not provide enough lower back support. One strategy is to choose an ergonomic office chair that often provides better support than a regular chair and may be more comfortable for the patient.

Take a Break from Sitting in an Office Chair
In addition, the spine is made for motion, and when sitting in any type of office chair (even an ergonomic office chair) for long periods of time, it is best to get up, stretch, and move around regularly throughout the day to recharge stiff muscles.

Identifying Incorrect Posture
The first step in improving posture is to identify what needs improvement by examining one’s own posture throughout the day, such as sitting in an office chair, carrying objects, or standing in line. At regular intervals during the day, take a moment to make a mental note of posture and back support. This should be done through the normal course of a day to best identify which times and positions tend to result in poor posture. Some people find it easier to ask someone else to observe their posture and make comments or suggestions.

Examples of Bad Posture and Back Support:
The following are examples of common behavior and poor ergonomics that need correction to attain good posture and back support:

  • Slouching with the shoulders hunched forward
  • Lordosis (also called “swayback”), which is too large of an inward curve in the lower back
  • Carrying something heavy on one side of the body
  • Cradling a phone receiver between the neck and shoulder
  • Pillows and Positions for Easing Neck Pain Video
  • Pillows for Neck Pain Video
  • Wearing high-heeled shoes or clothes that are too tight
  • Keeping the head held too high or looking down too much
  • Sleeping with a mattress or pillow that doesn’t provide proper back support, or in a position that compromises posture

Examples of Bad Posture While Sitting in an Office Chair
The following bad habits are especially common when sitting in an office chair for long periods of time

  • Slumping forward while sitting in an office chair
  • Not making use of the office chair’s lumbar back support
  • Sliding forward on the seat of the office chair

Posture to Straighten Your Back
As already discussed, for correction of poor posture it is important to determine where improvement is needed, such as when sitting in an office chair. Next, patients must work on changing daily habits to correct those areas. This effort will improve back support and over time help decrease back pain. It will take some effort and perseverance, and will seem a little unnatural at first. It is typical to feel uncomfortable, and even feel a little taller, but over time the new posture will seem natural and more comfortable.

Following are some guidelines of how to achieve good posture and ergonomics in the workplace and other situations.

  • Be sure the back is aligned against the back of the office chair. Avoid slouching or leaning forward, especially when tired from sitting in the office chair for long periods
  • For long term sitting, such as in an office chair, be sure the chair is ergonomically designed to properly support the back and that it is a custom fit.
  • When sitting on an office chair at a desk, arms should be flexed at a 75 to 90 degree angle at the elbows. If this is not the case, the office chair should be adjusted accordingly
  • Knees should be even with the hips, or slightly higher when sitting in the office chair
  • Keep both feet flat on the floor. If there’s a problem with feet reaching the floor comfortably, a footrest can be used along with the office chair
  • Sit in the office chair with shoulders straight
  • Don’t sit in one place for too long, even in ergonomic office chairs that have good back support. Get up and walk around and stretch as needed

Standing Posture

  • Stand with weight mostly on the balls of the feet, not with weight on the heels
  • Keep feet slightly apart, about shoulder-width
  • Let arms hang naturally down the sides of the body
  • Avoid locking the knees
  • Tuck the chin in a little to keep the head level
  • Be sure the head is square on top of the spine, not pushed out forward
  • Stand straight and tall, with shoulders upright
  • If standing for a long period of time, shift weight from one foot to the other, or rock from heels to toes.
  • Stand against a wall with shoulders and bottom touching wall. In this position, the back of the head should also touch the wall – if it does not, the head is carried to far forward (anterior head carriage).

Walking Posture

  • Keep the head up and eyes looking straight ahead
  • Avoid pushing the head forward
  • Keep shoulders properly aligned with the rest of the body

Driving Posture

  • Sit with the back firmly against the seat for proper back support
  • The seat should be a proper distance from the pedals and steering wheel to avoid leaning forward or reaching
  • The headrest should support the middle of the head to keep it upright. Tilt the headrest forward if possible to make sure that the head-to-headrest distance is not more than four inches

Posture and Ergonomics While Lifting and Carrying

  • Always bend at the knees, not the waist
  • Use the large leg and stomach muscles for lifting, not the lower back
  • If necessary, get a supportive belt to help maintain good posture while lifting
  • When carrying what a heavy or large object, keep it close to the chest
  • If carrying something with one arm, switch arms frequently
  • When carrying a backpack or purse, keep it as light as possible, and balance the weight on both sides as much as possible, or alternate from side to side
  • When carrying a backpack, avoid leaning forward or rounding the shoulders. If the weight feels like too much, consider using a rolling backpack with wheels.
  • See Avoid Back Injury with the Right Lifting Techniques

Sleeping Posture with Mattresses and Pillows

  • A relatively firm mattress is generally best for proper back support, although individual preference is very important
  • Sleeping on the side or back is usually more comfortable for the back than sleeping on the stomach
  • Use a pillow to provide proper support and alignment for the head and shoulders
  • Consider putting a rolled-up towel under the neck and a pillow under the knees to better support the spine
  • If sleeping on the side, a relatively flat pillow placed between the legs will help keep the spine aligned and straight.

It is important to note that an overall cause of bad posture is tense muscles, which will pull the body out of alignment. There are a number of specific exercises that will help stretch and relax the major back muscles. Some people find that meditation or other forms of mental relaxation are effective in helping relax the back muscles. And many people find treatments and activities such as massage therapy, yoga, tai chi or other regular exercise routines, or treatments such as chiropractic or osteopathic manipulation, etc. to be helpful with both muscle relaxation and posture awareness and improvement.

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Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.

 

Good Posture makes all the difference!

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How Poor Posture Causes Neck Pain

Article written by: Gavin Morrison, PT    www.spine-health.com

Most neck pain that is not caused by whiplash or other trauma has a postural component as part of the underlying problem. Sitting atop the body, the health of the neck is subject to the curvature of the spine below and the position of the head above.

The neck muscle pain can be caused by the following neck muscles becoming tight:

  • Scalene muscles (three pairs of muscles that help rotate the neck)
  • Suboccipital muscles (four pairs of muscles used to rotate the head)
  • Pectoralis minor muscles (a pair of thin triangular muscles at the upper part of the chest)
  • Subscapularis muscles (a pair of large triangular muscles near each shoulder joint)
  • Levator scapulae muscles (a pair of muscles located at the back and side of the neck).

If the alignment of the head and spine is not optimal, the neck can be predisposed to injury and/or the degenerative effects of wear and tear over time.

 

Forward Head and Shoulder Posture

The most common condition that contributes to neck pain is forward head and shoulder posture. Forward head posture is when the neck slants forward placing the head in front of the shoulders. This head position leads to several problems:

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  • The forward pull of the weight of the head puts undue stress on the vertebrae of the lower neck, contributing to degenerative disc disease and other degenerative neck problems.
  • Similarly, this posture causes the muscles of the upper back to continually overwork to counterbalance the pull of gravity on the forward head.
  • This position is often accompanied by forward shoulders and a rounded upper back, which not only feeds into the neck problem but can also cause shoulder pain.

The more time spent with a forward head posture, the more likely it is that one will develop neck and shoulder problems.

 

Effects of Poor Posture on the Lower Cervical Vertebrae

The part of the neck that is particularly vulnerable to forward head posture is the lower part of the neck, just above the shoulders.

The lower cervical vertebrae (C5 and C6) may slightly slide or shear forward relative to one another as a result of the persistent pull of gravity on a forward head.

This shear force can be a problem for patients with jobs that require them to look down or forward all day, such as pharmacists who spend many hours counting pills or data entry workers who look at a computer screen.

Long-Term Negative Effects of Poor Posture

Prolonged shearing of the vertebrae from forward head posture eventually irritates the small facet joints in the neck as well as the ligaments and soft tissues.

This irritation can result in neck pain that radiates down to the shoulder blades and upper back, potentially causing a variety of conditions, including:

 

Workplace Ergonomics and Neck Pain

It is often important to look at the workplace ergonomics as part of treatment and prevention of neck pain. Perhaps the placement of the desk, computer workstation and/or placement of the computer monitor and keyboard can be improved to encourage improved upper back and neck posture.

When sitting erect at a desk and looking straight ahead:

  • Eyes should point directly at the top third of the screen.
  • Forearms should be approximately parallel with the floor when typing.
  • Elbows should be at the side.
  • Feet should be flat on the floor with the thighs parallel with the floor.

If patients have a standing work station or perform other sorts of sitting or driving tasks, make sure that one side of the body is not constantly rotated more than the other side, and that there is as much symmetry in repetitive tasks as possible.

Persistent movements to one side or constant rotation of the neck and back to the same side can often aggravate joints and soft tissues causing neck and back pain. Some patients can develop poor posture of the head, neck, and shoulders through repetitive work tasks and/or poor sitting habits.

There are stretches and exercises that are effective at helping restore good posture, thereby taking pressure off the neck and relieving pain.

See Simple Office Chair Stretch

BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton  office at 540-347-9220 or our Gainesville office at 703-743-2814.

Chronic Pain Coping Techniques – Pain Management

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Article written by: Andrew R. Block, PhD   Spine-Health.com

Clinicians who specialize in treating chronic pain now recognize that it is not merely a sensation, like vision or touch, but rather chronic pain is strongly influenced by the ways in which the brain processes the pain signals.

Chronic pain can provoke emotional reactions, such as fear or even terror, depending on what we believe about the pain signals. In other cases (such as in sports or another engaging, rewarding activity), chronic pain may be perceived by the individual as merely a nuisance, a feeling to be overcome in order to be able to continue in the activity.

The important role the mind plays in chronic pain is clearly recognized in the medical literature, as well as in the International Association for the Study of Pain’s definition of pain, which states that pain is always subjective and is defined by the person who experiences it.

The corollary is that the brain can also learn how to manage the sensation of pain. Using the mind to control chronic pain, or coping strategies, for managing persistent pain, may be used alone or in tandem with other pain management therapies.

Ideally, use of the chronic pain management techniques outlined in this article can help patients feel less dependent on pain killers and feel more empowered to be able to control their pain.

Managing Chronic Pain

Of course, the first step in coping with chronic back pain or other types of persistent pain is to receive a thorough medical evaluation to determine the cause of the pain.

  • In some situations, such as a herniated disc in the spine, it may be important to pay attention to the level and type of pain so that it can serve as a warning signal of impending damage.
  • In other cases, especially when the back pain is chronic and the health condition unchangeable, one goal can be to try and keep the chronic pain from being the entire focus of one’s life.

Whatever the medical condition, there are a number of effective strategies for coping with chronic back pain. These techniques generally include:

  • Relaxation training: Relaxation involves concentration and slow, deep breathing to release tension from muscles and relieve pain. Learning to relax takes practice, but relaxation training can focus attention away from pain and release tension from all muscles. Relaxation tapes are widely available to help you learn these skills.
  • Biofeedback: Biofeedback is taught by a professional who uses special machines to help you learn to control bodily functions, such as heart rate and muscle tension. As you learn to release muscle tension, the machine immediately indicates success. Biofeedback can be used to reinforce relaxation training. Once the technique is mastered, it can be practiced without the use of the machine.
  • Visual imagery and distraction: Imagery involves concentrating on mental pictures of pleasant scenes or events or mentally repeating positive words or phrases to reduce pain. Tapes are also available to help you learn visual imagery skills.

Distraction techniques focus your attention away from negative or painful images to positive mental thoughts. This may include activities as simple as watching television or a favorite movie, reading a book or listening to a book on tape, listening to music, or talking to a friend.

  • Hypnosis: Hypnosis can be used in two ways to reduce your perception of pain. Some people are hypnotized by a therapist and given a post-hypnotic suggestion that reduces the pain they feel. Others are taught self-hypnosis and can hypnotize themselves when pain interrupts their ability to function. Self-hypnosis is a form of relaxation training.

All of the above-describe techniques for coping with chronic back pain make use of four types of skills:

  • Deep Muscle Relaxation
  • Distraction: moving attention away from the pain signals
  • Imagery: visual, sound or other pictures and thoughts that provide a pleasant and relaxing experience
  • Dissociation: The ability to separate normally connected mental processes, leading to feelings of detachment and distance from the chronic pain.

11 Chronic Pain Control Techniques

To prepare for any chronic pain coping technique, it is important to learn how to use focus and deep breathing to relax the body. Learning to relax takes practice, especially when you are in pain, but it is definitely worth it to be able to release muscle tension throughout the body and start to remove attention from the pain.

Coping techniques for chronic pain begin with controlled deep breathing, as follows:

  • Try putting yourself in a relaxed, reclining position in a dark room. Either shut your eyes or focus on a point.
  • Then begin to slow down your breathing. Breathe deeply, using your chest. If you find your mind wandering or you are distracted, then think of a word, such as the word “Relax,” and think it in time with your breathing…the syllable “re” as you breathe in and “lax” as you breathe out.
  • Continue with about 2 to 3 minutes of controlled breathing.
  • Once you feel yourself slowing down, you can begin to use imagery techniques.

Eleven specific imagery and chronic pain control techniques that are effective for pain control include:

  1. Altered focus
    This is a favorite technique for demonstrating how powerfully the mind can alter sensations in the body. Focus your attention on any specific non-painful part of the body (hand, foot, etc.) and alter sensation in that part of the body. For example, imagine your hand warming up. This will take the mind away from focusing on the source of your pain, such as your back pain.
  2. Dissociation
    As the name implies, this chronic pain technique involves mentally separating the painful body part from the rest of the body, or imagining the body and mind as separate, with the chronic pain distant from one’s mind. For example, imagine your painful lower back sitting on a chair across the room and tell it to stay sitting there, far away from your mind.
  3. Sensory splitting
    This technique involves dividing the sensation (pain, burning, pins and needles) into separate parts. For example, if the leg pain or back pain feels hot to you, focus just on the sensation of the heat and not on the hurting.
  4. Mental anesthesia
    This involves imagining an injection of numbing anesthetic (like Novocain) into the painful area, such as imagining a numbing solution being injected into your low back. Similarly, you may then wish to imagine a soothing and cooling ice pack being placed onto the area of pain.
  5. Mental analgesia
    Building on the mental anesthesia concept, this technique involves imagining an injection of a strong pain killer, such as morphine, into the painful area. Alternatively, you can imagine your brain producing massive amount of endorphins, the natural pain relieving substance of the body, and having them flow to the painful parts of your body.
  6. Transfer
    Use your mind to produce altered sensations, such as heat, cold, anesthetic, in a non-painful hand, and then place the hand on the painful area. Envision transferring this pleasant, altered sensation into the painful area.
  7. Age progression/regression
    Use your mind’s eye to project yourself forward or backward in time to when you are pain-free or experiencing much less pain. Then instruct yourself to act “as if” this image were true.
  8. Symbolic imagery
    Envision a symbol that represents your chronic pain, such as a loud, irritating noise or a painfully bright light bulb. Gradually reduce the irritating qualities of this symbol, for example dim the light or reduce the volume of the noise, thereby reducing the pain.
  9. Positive imagery
    Focus your attention on a pleasant place that you could imagine going – the beach, mountains, etc. – where you feel carefree, safe and relaxed.
  10. Counting
    Silent counting is a good way to deal with painful episodes. You might count breaths, count holes in an acoustic ceiling, count floor tiles, or simply conjure up mental images and count them.
  11. Pain movement
    Move chronic back pain from one area of your body to another, where the pain is easier to cope with. For example, mentally move your chronic back pain slowly into your hand, or even out of your hand into the air.

Some of these techniques are probably best learned with the help of a professional, and it usually takes practice for these techniques to become effective in helping alleviate chronic pain. It is often advisable to work on pain coping strategies for about 30 minutes 3 times a week. With practice, you will find that the relaxation and chronic pain control become stronger and last longer after you are done.

Sometimes, after you are good at using the techniques, you can produce chronic pain relief and relaxation with just a few deep breaths. You can then start to use these techniques while you are engaged in any activity, working, talking, etc. With enough experience you will begin to feel a greater sense of control over the chronic pain and its effects on your life.

 

BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton  office at 540-347-9220 or our Gainesville office at 703-743-2814.

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