Dooley Noted: 5/29/2015
The women in this video is 75.
She has a 35-year history of ankylosing spondylitis, a disabling spinal disorder typically coupled with pain and reduced ranges of motion.
She has over 20 pins in her spine, as well as a total hip replacement and a bunionectomy.
Watch the video, and guess her chief complaint.
I’ll wait.
Do you have your guess ready?
Her chief complaint is a lack of neck movement. She wants to turn her neck.
She has no pain whatsoever.
Movement dysfunction and structural changes are not the only components of pain.
Should they be included in an analysis? Of course.
But one must analyze many factors of pain, which include, but are not limited to, the following:
1. Environment
2. Memory programming of pain (i.e., cerebral programming)
3. Systemic inflammation
4. Pain receptor irritation
5. Heightened awareness, due to neurotransmitter activity/inactivity (i.e., drug exposure, depression)
6. Circulatory issues (i.e., blood stasis
7. Fatigue and energy deficient
8. Improper hydration/dehydration
9. Psycho-social components (i.e., your back hurts because you hate your job or your in -aw)
10. And I am sure, many things more I didn’t include.
My intake is long. And never once have I said to a patient, “Oh, you have a funky gait or radiographic findings. You MUST have pain.”
Pain is multifactorial.
Don’t marry any of the above pain correlations.
Like most things, pain can change.
And looks can be deceiving.
This is why the clinicians at Catalyst SPORT treat the PERSON, not just the movement findings or the structural findings.
Look at each piece of the puzzle – and listen to your patient.
As always, it’s your call.
– Dr. Kathy Dooley