The pain doesn’t limit itself to the occurrence of the injury. The body continues to send different signals to the brain during the healing process. A good example is what occurs as a laceration heals. Blood coagulates and clots, forming a “scab” which is usually a source of itchiness.
So let’s say, for example, you cut the palm of your right hand, it heals, and it starts to scab over. The itchiness you now feel can be taken as a warning to not use your right hand to grip hard or carry heavy objects since your wound may re-open. That pain, or any other number of different sensations that you may feel post-injury, is your body’s way of communicating with you. That communication isn’t perfect. Even after the original injury has healed, your body can still send pain signals, and the more intense the original injury was, the more complicated the healing process can be.
A further complexity is that as the original injury heals, the body’s natural tendency to protect itself lends to compensating for the injury with other body parts. So in the original example of cutting your palm, the pain you feel when you grab something with your injured hand might lead to the use of your non-injured hand instead. In cases where you would normally use multiple body parts to perform a certain task, your body would not only compensate, but in some cases overcompensate to complete a function. Using the cut palm as an example again, let’s say that you have to use both hands to push on an object and exert force similar to that of a push-up.
Your body would normally perform the pushing motion with moments (forces) distributed in a certain way among your chest, arms, shoulders, back, and legs. Since one of your hands was injured, you would have a tendency to shift more weight to the uninjured hand and your shoulder, chest, and arm connected to the uninjured hand would bear more load (weight). Building on that example even further, let’s say that you are a mover, and that it was a deep cut that was constantly being aggravated by displacing heavy objects with two hands. Over time, or in an instance of bearing an extreme weight, a secondary injury could occur due to the overcompensation of your injury. This cycle is the one of the reasons why recovery from a serious injury can be difficult. It is often heard from athletes recovering from major injuries that they have to “re-learn” how to move and play their sport.
The muscle memory you once had when performing certain functions has to be re-programmed into the new set of physical abilities you have after an injury has healed. The more extreme and disruptive the injury, the more that has to be re-learned. Especially disruptive are the injuries that occur around the spine and neck. Any major physical traumas that affect the spine and neck elicit a very protective response from the muscles surrounding them.
These muscles tighten up to prevent the spine and neck from being overextended or severed, and remain tight even after the main trauma has ended. Whiplash patients can experience sore necks on a daily basis for years after an accident, as the tight neck becomes a new muscle memory. Manual manipulation has long been accepted as a method in the rehabilitation process. Chiropractors, osteopaths, and physical therapists have specialized in Osteopathic Manipulative Therapy (OMT) to help injured patients get range of motion, strength and flexibility back.
For many, OMT is a complete solution. All professional sports teams have some form of OMT as part of their normal training and recovery process. There are many cases, however, where range of motion has been re-achieved and strength has returned, but chronic pain still remains. Interventional pain management is a growing field in medicine that is a specialty within the field of anesthesiology. Pain management doctors focus on the pain itself and have an array of treatment methods at their disposal that can help diminish and even disrupt the pain signals that may still be present long after the injury has healed.
The next article in this series will feature an interview with an Interventional Pain Physician and delve further into different types of treatment options that are available to the patient in pain.
Eric Noble Castillo is a freelance health writer, former NCAA Division I Volleyball trainer, and former European basketball coach.
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