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Understanding Mechanical Pain

12/31/2013

2 Comments

 
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This editorial was brought to me during my residency at Harris Health. It is written by Jason Silvernail on the website SomaSimple. 

As therapists we often deal with 2 types of pain: Chemical and Mechanical. Understanding the difference between the two is important because it allows you to explain to your patients "why" they are experiencing pain. Chemical Pain is associated with inflammation, and responds positively to anti-inflammatory medication and rest. Mechanical Pain is more complex! It is due to prolonged pressure or tension on nervous tissue. When you see a patient with mechanical pain, they may have questions regarding why their MRI did not show anything significant OR why their medications are not working. This is because Mechanical Pain is due to how the tissue feels, and not the way the tissue looks. There is no acute inflammation and no acute tissue damage. Mechanical pain is a chronic irritation. To fix mechanical pain, we need prescribe movements that relieve the tension that is being placed on the nervous system. This specific movement will gradually or immediately allow the patient to experience less pain. The patient needs to be regularly reversing the postures that are placing tension on their nervous system. This is where doing your Home Exercise Program regularly becomes so important. Sometimes it can be difficult to tell a patient to MOVE when they are in pain, but by educating them that the specific exercises you are prescribing are actually taking tension off the involved structures can be a great for compliance.
 
The last point I will touch on is how many sets and reps should be prescribed for mechanical pain. As therapists, we know how many repetitions to prescribe for strength training, neuromuscular re-education, and power, but how many reps do you prescribe for pain? The answer is unique to each patient and will vary based on comorbidities, irritability level, etc... I would recommend starting with a high repetition, low load dosage. This will minimize the risk for compensations, decrease the risk of increasing symptoms, and hopefully get the patient performing them more frequently.  

Reference:
Silvernail, J. "Understanding Mechanical Pain." Somasimple.com. Web. 14 Dec. 2013.
2 Comments
testmyspeed.onl/ link
1/26/2024 08:37:53 am

Instead of passively guessing a patient's prognosis, I learned to actively create a plan of care with a predictable prognosis. As my knowledge improved, my outcomes continued to get better!

Reply
Botox Treatment link
5/7/2024 01:02:19 am

Mechanical pain arises from physical strain or damage to the musculoskeletal system, often due to repetitive motions or improper posture. It can manifest as aching, stiffness, or even shooting pains in various parts of the body. Identifying the source of this discomfort is crucial for effective treatment. Techniques like physical therapy and ergonomic adjustments can alleviate symptoms, but in some cases, Botox treatment may be a viable option. This involves injecting botulinum toxin into affected muscles to reduce tension and alleviate pain. Ultimately, a multi-faceted approach is often required to manage and understand mechanical pain effectively.

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  • Home
  • About Us
  • TSPT Academy
  • Resources
    • Newsletter
    • Orthopedic Blog
    • Featured Articles
    • Research Articles
    • Residency Corner
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test