Ask An Expert: Pain and Physical Therapy

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Ask An Expert: Pain and Physical Therapy

Question:

I was in a car accident four weeks ago. I have had physical therapy for the last three weeks and it seems to hurt more than it helps. I am still feeling pain and spasms. Can you suggest another option?

Answer:

It is important to check in with your doctor if you have persistent pain after trauma; however, it is not at all unusual to have pain for weeks or even months after a car accident. The impact of a motor vehicle accident can be very forceful and can affect many parts of your body simultaneously.

The most common musculoskeletal injuries are sprain/strain injuries of the muscles, tendons and ligaments.

After this kind of injury, it's important to recognize that pain begets more pain. This means that when you have pain and this causes you to avoid moving, your muscles go into even more spasm. This can lead to a vicious cycle of more and more pain and less and less movement.

Physical therapy is very helpful in breaking this cycle, but not everyone can tolerate it. When someone can't tolerate therapy, I consider whether there is a need for more or different medications to try to control the pain and break the cycle.

Sometimes passive therapies such as acupuncture and massage can help lessen pain, too. I think these are great to try, but it's important to keep in mind that in order to heal well, you need to physically regain strength and flexibility. Medications and passive therapies cannot improve these. They may help decrease pain so that a person can begin the physical work of regaining strength and flexibility after an injury.

If someone can't tolerate physical therapy in a gym (what rehab professionals often call "land therapy"), then I recommend trying physical therapy in the water ("pool therapy"). The buoyancy of the water makes it much easier to move about.

If you recently sustained trauma and are having persistent pain:

• Check with your doctor to make sure that there are no injuries that have not been identified.

• Ask your doctor about medications or other therapies that might help better control your pain.

• Consider switching from land therapy to pool therapy.

• Be patient. Traumatic injuries can take weeks to months to heal optimally.

Last updated:	June 07, 2007