Treat The Pain Experience, Not Just The Result

blog guest blog pain Jan 24, 2022

Guest blog post written by Megan North, currently enrolled in Western University’s Masters of Interprofessional Pain Management program.

The soccer field is freshly cut, and lines are newly drawn. It's game day. Tom is putting on his cleats, getting ready for the season's first game. In the blink of an eye, there are only five minutes left of the game, and it's tied 2-2. Tom has possession of the ball; he's fast and tries to beat the defender in front of him. BAM! Tom is down, lying there in the grass, holding his knee. Something is wrong…. His teammates gasp as his knee swells, turning purple and blue. 

Tom is experiencing acute pain. A pain that people can see. This pain should only be temporary. 

Three months go by, Tom's knee has healed, and he has been cleared to return to play. But, he is still experiencing pain. He is afraid to sprint, afraid to push himself too hard. When Tom steps on the field, he has an overwhelming sense of anxiety.

Tom is now experiencing chronic pain. His pain is invisible. 

Unfortunately, this scenario is all too common. Pain is complex, and we are only beginning to understand the intricacies. 

"Chronic pain is not all about the body, and it's not all about the brain - it's everything. Target everything. Take back your life."

- Sean Mackey, MD, PhD

 

In research, early pain models were focused on the biology or the pathophysiology components of pain (Gatchel, 2005). We are now coming to understand that to manage pain effectively; we need to take a multifaceted approach. The most commonly known and researched is the biopsychosocial approach to pain. No two people are alike; their pain experiences will vary based on the range of interactions between these factors, adjusting a person's interpretation of their symptoms. (Gatchel, 2005) (Turk et al., 2002).

Most of you are probably already doing this without even realizing it. By providing your client with therapeutic exercises, you address the biological aspect, allowing them to vent their frustrations and address fearful movements. You are managing the psychological, and by simply encouraging your client and having a solid support system, the social aspect is met too. 

Some cases may be more complex, and they may need more time or support. Having a solid referral network is essential to be as effective when managing pain as quickly as possible. This referral network might include a social worker, psychologist, medical doctor, naturopath, massage therapist, etc. This referral network is essential for people with a history of trauma, lack of social support, extreme kinesiophobia, and anything you as the kinesiologist does not feel comfortable addressing or is outside your scope of practice. 

Knowing that many factors can affect pain, which do you address first?

Which is most important? Below is an image of the Radar Plot. I use this tool in practice with my clients to help them understand that pain is not only physical. In addition, the Radar Plot helps set goals and gives a sense of agency to clients. The Radar Plot also provides clients with the opportunity to increase their awareness of which factors they would like to prioritize (Walton & Elliot, 2018).

The video below explains how to use the 7- point Radar Plot.

 

 

A highly underutilized tool that, as kinesiologists, we possess is our knowledge. Simply educating clients on the issue at hand can empower them, decreasing their pain. Help your clients better understand WHY they are experiencing pain, the factors that affect pain and why it is essential to use a holistic approach. 

Pain is ambiguous; pain is fear; pain is unique; pain is invisible; pain is an experience. 

Now back to Tom. Having learned this information, what approach would you take? Is it a different path than what you would have considered before? 

 

References

Gatchel RJ. Clinical Essentials of Pain Management. American Psychological Association. Washington, DC. 2005.

Turk DC and Monarch ES. Biopsychosocial perspective on chronic pain. In: Turk DC, Gatchel RJ, eds. Psychological Approaches to Pain Management: A Practitioner's Handbook. 2nd ed. Guilford. New York. 2002.

Walton, D. M., & Elliott, J. M. (2018). A new clinical model for facilitating the development of pattern recognition skills in clinical pain assessment. Musculoskeletal Science and Practice, 36, 17–24. https://doi.org/10.1016/j.msksp.2018.03.006

 


Megan has her Bachelor of Human Kinetics with a minor in psychology from the University of Windsor, Ontario. Currently enrolled in the third cohort of Western University’s Masters of Interprofessional Pain Management program. She is the first Registered Kinesiologist to be offered admission. Now, working at a Community Health Centre as a Registered Kinesiologist and a Chiropractic facility as the Technical Coordinator, she is no stranger to pain. In addition, Megan enjoys camping, sports, and being with her friends and family in her spare time. You can reach Megan here: @rkinmeg & https://thesecrettopain.blogspot.com/

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