Your Pain’s Location May Not Be Its Source

Pain is a confusing topic. And there’s lots of advice out there on what to do about it.

Should you rest? Should you exercise? Apply heat or ice? Do you see a doctor? Or let it go away on its own?

Before you can even think about a solution to your pain, you must first accurately determine where it’s coming from. If you have pain in your knee, and it’s coming from your back, for example, the best treatment in the world isn’t going to fix it. Inaccurate diagnosis of pain is one of the biggest reasons why so many people suffer longer than they need to, and why they undergo unnecessary surgeries. You must accurately determine the source of your pain for treatment to be effective. And the location of your pain is not a reliable way to figure out where it’s coming from.

For example,

I’ve met people who’ve suffered from unrelenting tennis elbow for years, only to find out it was coming from their neck. It’s why all the elbow and arm treatment in the world wasn’t solving their problem. I’ve met people who’ve undergone major knee surgery and it failed – only to find out later they never actually had a knee problem. Their pain was coming from their lower back – it just got missed – or was never even considered.

Isolated extremity pain (knees, elbows, shoulders) is one of the most mis-diagnosed problems in the musculoskeletal world. In a study published in the Journal of Manipulative Therapy, Richard Rosedale, et al found that over 40% of people suffering from isolated extremity pain had a spinal source responsible for their symptoms. In other words, the pain they were feeling in their knee or shoulder was actually coming from their back or neck (respectively).

Confused? I don’t blame you. But more importantly, how do you reliably figure out the source of your pain when it’s not always where you’re feeling it?

As already mentioned, the most common place for this to happen is with extremities.

If you’ve got shoulder, elbow, or knee pain, and you don’t recall having a specific injury to it, you must consider that it could be coming from your spine. There’s a 44% chance that it is. Where this gets really confusing is that typically, when you’ve got isolated knee or shoulder pain that won’t go away, your doctor will order an MRI. And if you’re over 40 years old, the MRI will almost always show “something”. It could be a torn rotator cuff, torn meniscus, arthritis, or wear and tear.

What most people don’t realize is that these findings are quite normal and happen naturally as you age. Just because they show up in your MRI – doesn’t mean they are responsible for your pain. Despite studies showing this to be true, doctors continue to order these tests and rely on them to make important decisions about treatment. It’s how people end up undergoing unnecessary procedures or surgery.

Whenever I meet someone with isolated extremity pain, especially if it came out of nowhere, I always consider that it could be coming from their spine. How can you figure this out? Well, it’s challenging to figure it out on your own. But if you work with a movement specialist who understands this concept – you’ll be able to figure this out accurately. The basic premise is that if you can move your spine in specific directions – repeatedly – and influence the symptoms you feel in your extremity – then there is a very good chance your problem is coming from your spine. Or at the very least, your spine is involved. And whenever your spine is responsible solely or partially for pain elsewhere – and it’s ignored – your problem will persist and likely get worse over time.

If you’ve had pain in one of your extremities for a while now, and it’s not going away, it’s possible you’ve missed the source.

That source could be your spine. And if you’re considering some kind of surgery or procedure, you definitely want to rule this out first. Specialized movement exams are one of the most reliable ways to figure this out – studies have proven it. If you’ve had unexplained pain in your knee or shoulder that isn’t going away, look for someone who understands this and can give you a proper movement exam to accurately identify the source of your pain.

Ready to get help with your pain?

Request to speak to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group.

Here are 5 tips to ease back and neck pain during Holiday travel:

1. Walk at Rest stops and Airports

Walking is not only great exercise but it’s well known for helping ease back and neck stiffness. Our bodies like to be upright and generally don’t like to be still and sitting for very long. If you’re flying somewhere this Holiday season, walk around the terminal while waiting for your flight instead of sitting. Don’t take the people mover – get those extra steps in and walk instead. If you’re driving somewhere long distance, make a point to stop along the way and be sure to get out and walk a little. Bonus – walking is great for hip and knee stiffness too.

2. Stay Hydrated

When it comes to back and neck pain – people don’t really think of hydration as something that makes a difference. The discs between our vertebrae need fluid to do their job – which is to provide cushion and shock absorption. They can get dry and brittle when not properly hydrated which can exacerbate back and neck pain. When you add travel to the mix, which involves a lot more sitting than you might do on a normal day, you put even more stress on your discs. So remembering to drink enough water when you travel is very important. Opting for foods like watermelon, lettuce, spinach and soups can help you stay hydrated as well as avoiding beverages that contain caffeine and alcohol.

3. Interrupt your Sitting

If you make a point to walk when you can, and drink plenty of water, interrupting your sitting is going to naturally happen and not be that difficult. As I mentioned already, our bodies were not meant to be sitting for prolonged periods and it’s one of the top reasons so many people suffer from unnecessary back and neck pain. When you sit, there is more pressure on your vertebral discs. But more than that, they start to weaken in certain areas from too much sitting – making you more susceptible for a disc bulge or herniation. Prolonged sitting also puts extra stretch on your muscles. Over time this contributes to them losing their elasticity – making them weaker and more painful – and easier to strain. My general rule is to always interrupt your sitting at least once every 30 min. This interruption acts as a reset button for your spine and helps to minimize the cumulative forces responsible for all of the problems I just mentioned.

4. Stretch in your Seat

If you absolutely can’t stand up and interrupt your sitting – the next best thing is to move and stretch in your seat. While it’s not as ideal as standing up – it’s certainly better than just sitting there. My two favorite stretches to do while sitting are: 1) the chin tuck and 2) thoracic extension.

To perform the chin tuck…

To stretch your thoracic spine…

5. Use a lumbar Roll

Our spine is made up of distinct curves for a very good reason. They are designed to balance forces and sustain shock – and it’s best if you can maintain them. When you sit, the curve in your lower back (lumbar spine) decreases, or sometimes disappears all together. While it’s perfectly acceptable to sit like this for small increments of time (remember the 30 min rule), your spine will not like this after several hours. Plus, your neck responds by changing it’s curve to a “forward head” position as well. One of the best things you can do is use a cylindrical lumbar roll to help maintain the natural curve in your lumbar spine. Place it right at your lower back any time you’re sitting and you’ll find that your back and neck have a lot less strain.

Tag Archive for: easing back and neck pain