Chronic Pain

Chronic Pain

 

By definition, Chronic Pain is persistent pain that lasts longer than 12 weeks. Most people may be new to the notion of chronic pain because we have the common belief that pain goes away when tissues heal after an injury or illness, usually less than 12 weeks. However, this is not the case for 1 in 5 Australians and pain may not lessen even when the healing process is complete.

Chronic pain is complex and can be frustrating because it involves the nerves and nervous systems.  Chronic pain occurs because of changes to the nervous system, which keeps the nerves firing and signaling pain. However, there are likely to be other factors that can contribute to chronic pain, including; genetics, gender and previous episodes of acute pain.  Chronic pain can be intense and unrelenting, and lead to various degrees of disability if it is not well-managed.

Chronic pain refers to the amplification of pain by the central nervous system. Pain itself often modulates the way the central nervous system does, meaning a chronic pain patient can become more sensitive and get more pain with less provocation over time.

Chronic pain is a grey area in health care. Because tissues have healed, however, the alarm system and brain have changed in an effort to protect you, diagnoses based on tissue processes are no longer fit. Patients end up with multiple theories depending on which healthcare practitioner they see.

For people with chronic pain from Fibromyalgia sufferers to a whiplash victim, changes in the spinal cord and the brain may no longer receive accurate information about what is happening in the tissue. In this sensitized state, the brain is being fed information that no longer reflects the true health and abilities of the tissues at the end of the nerve. Brain responses such as movement, thoughts, or autonomic, endocrine and emotional responses, are now based on faulty information about the health of the tissues at the end of the nerve.

Due to the complexity of chronic pain, it is important to be under the care of a healthcare practitioner who thoroughly understands the chronic pain pathways. This ensures that your pain can be properly managed and you can have a better understanding of your body and pain.

At Enhance Physiotherapy we use the latest up-to-date research and treatment techniques to treat chronic pain and we understand the frustrations behind the pain. We are here to plan, treat and offer options for you to lead a life that has pain at a manageable level.

Book your Enhance Experience online, or call us today.

Dry Needling

Dry Needling
Dry Needling
Dry Needling

Acupuncture, or Dry Needling as we sometimes refer to it, is starting to become common practice amongst Physiotherapists today. At Enhance Physiotherapy all our Physiotherapists are trained in the use of Dry Needling and we use it on a daily basis to help manage pain and muscle tightness amongst other things. But what is Dry Needling? How does it work?

Although there are differences between the terms ‘Acupuncture’ and ‘Dry Needling’, we will use them interchangeably throughout this information. In practice we use Dry Needling, but often refer to it as Acupuncture so people know what we’re talking about.

Dry Needling involves inserting a very fine needle into a muscle. Once the needle is in position it is left in the muscle for a short period of time (normally anywhere from 5 seconds to 15 minutes) before it is removed. Your therapist may choose to adjust or ‘twirl’ the needle while it is in place to maximise the effects. Sometimes your therapist will insert just one needle or they may insert several, depending on the area being treated and the desired effect.

Myofascial Trigger Points (MTPs), more commonly known as ‘knots’ in a muscle, are a common cause of pain and disability in the neck, shoulders and lower back. But they occur naturally in all muscles. When a muscle is put under stress, either due to poor posture or from excessive workload, these trigger points become exacerbated and increase in tension. What this means is that the muscle fails to relax adequately and remains active. This overall increase in muscle activation depletes the muscles energy, which can lead to further muscle tension as muscles require energy to relax.

Dry Needling helps by breaking this cycle of muscle tension, fatigue and aching. Inserting a needle into these MTPs elicits a twitch in the muscle which helps to release the bonds between muscle fibres, allowing the muscle to relax. Dry Needling also causes stimulation of nerves which transmit pain. This activates cells in the brain and spinal cord to suppress pain signals. As well as breaking down trigger points and suppressing pain signals, Dry Needling also triggers an increase of blood flow to the area being treated. Adequate blood flow is essential in the healing of body tissues because it supplies nutrients and blood cells to allow healing to take place, and it removes debris and dead cells caused by the initial injury.

Is Acupuncture safe?
Yes. Dry Needling is an EXTREMELY safe form of treatment. Side effects include:

  • Bruising: Occur in 3% of treatments
  • Infection: very rare; occur in 0.014% of treatments
  • Fatigue: prevalence not known (but in our experience is uncommon)
  • Fainting: very rare, but can occur particularly in patients who have never had it before and if patients are afraid of needles in general.

All our therapists are trained in the proper use of dry needling and we use sterile, single-use needles only to avoid side-effects.

At Enhance Physiotherapy we use Dry Needling on a regular basis, but often in conjunction with other therapies or treatments to form a holistic treatment approach. We think acupuncture/dry needling is a fantastic tool to have at our disposal. For those clients who feel anxious or uncomfortable about the use of needles in their treatment we will always be able to provide different forms of therapy to effectively manage their injury.

If you would like to give dry needling a try, or have any questions about needling then ask your Physiotherapist.

Benefits of Hydrotherapy

Hydrotherapy at Enhance Physiotherapy
Hydrotherapy at Enhance Physiotherapy

Hydrotherapy involves completing aerobic and resisted exercises in a body of water. Therapy pools are normally warmer than the average swimming pool to soothe painful muscles and joints. As well as the pain relieving effects from the warm water, hydrotherapy also creates an environment where there is less force being put on painful joints in the ankles, knees, hips and spine. The buoyancy of the water creates a force that is opposite to that of gravity which unloads these painful structures.

We use hydrotherapy for a number of different injuries:

  • Post-operative: Hydrotherapy is especially useful for early stage rehabilitation following joint surgeries such as hip/knee replacements, ligament reconstructions or post fracture. In the first 4-8 weeks after surgery (varies between procedures) people experience pain with putting their bodyweight through the affected area. Hydrotherapy allows us to get these patients walking normally earlier in their rehabilitation process by reducing these forces.
  • Chronic Pain: People with Chronic pain often have difficulty with exercising because even with low to mid impact exercise such as walking their pain levels flare up. Hydrotherapy is a great way for these people to exercise at lower impact while still challenging the muscles and cardiovascular system.
  • Arthritis: Arthritis falls in a similar basket to chronic pain – as patients load their joints up during full weight bearing exercise they may experience pain. Exercising in the water reduces this load and allows them to exercise pain free. The warmth of the water is also extremely beneficial for aching and stiffness associated with arthritis.
  • Sports Injuries/Recovery: Hydrotherapy is also excellent for recovering from post-match or training soreness as well as muscle injuries. As well as the benefits mentioned above, the water exerts ‘hydrostatic pressure’ onto the submerged areas which creates a compression effect. This means that any inflammatory response occurring will be reduced.

As well as the injuries and condition mentioned above, hydrotherapy gives the same benefits as regular exercise. Regular hydrotherapy improves heart and lung function, circulation, muscle strength and endurance and releases endorphins which are good for mental health.

If you have any pre-existing medical conditions be sure to consult your Doctor or Physiotherapist before partaking in any form of exercise.

Find out when our Hydrotherapy classes run by clicking here.