Start At The End
Invert Conventional Care
This is how most neck and head pain patients travel through the medical system in a search for relief.
They begin with medications—non-steroidal anti-inflammatories, non-opiate pain meds, muscle relaxers, and central nervous system modulating drugs. This can go on for weeks, months, and even years.
Progression of pain or just no improvement in symptoms leads to imaging- an x ray, CT scan, and / or the ever popular MRI. Despite the fact that nearly everyone has something wrong on their cervical imaging, care is now directed at the faulty anatomy. There is your problem–you need a specialist. Next patient.
The persistent pain must be caused by this anatomical alteration so site-specific injections and surgery become the treatment of choice. Finally, after many injections and all too often cervical fusion surgery, the patient in referred for physical therapy.
While working with a therapist trained in spinal care, the patient learns that most head and neck pain problems have multiple drivers. The patient adopts posture correction, lifestyle modification, and a consistent exercise routine. Manual therapy and pain relief activities are part of an ongoing program of progressive treatment. Pain that has been present for months requires a specific exercise prescription and small changes in pain gives your therapist the insight they need to direct your care. Always treat with the same physical therapist as consistent communication is a critical aspect of care.
The longer the pain has been present in your head, neck, and arms, the longer it will take to resolve. Long standing symptoms create over active pain pathways and a central nervous system that is more sensitive noxious stimulus. Prolonged pain causes fear of activity and physical deconditioning that leads to spinal dysfunction.
If you have a history of head and neck pain, I encourage you to start your search for relief with a physical therapist. It is the treatment that is most likely to produce good results with minimal side effects. We will reduce suffering, save time, and lower health care costs with the inversion of the conventional treatment pathway.
Michael S. O’Hara, PT, OCS, CSCS