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Top 20 Myths About Pain

berold Injury Prevention, Myths, Pain, Physiotherapy, Rehabilitation Comments Off on Top 20 Myths About Pain

Top 20 Myths About Pain

By Dan Woywitka (

Myth #1: Women and Men Feel and Perceive Pain The Same

It is most common to see women pointing to childbirth as a measure by proof and intensity of their greater capacity for pain. Funny thing is, the science seems to support this.
Clearly women and men tolerate and experience pain in different manners. Women tend to use more coping mechanisms for pain. Seeking treatment more expeditiously, all the while recovering from pain at a great rate than men.
Experts agree that pain is so highly subjective to our experiences, that it is clearly very difficult to compare one person’s pain to another’s.

Myth #2: Rest Is The Best For Back Pain

It is very important to understand that whilst short term rest is often prescribed, it is still preferable to keep your body active. Experts agree that prolonged or total bed rest will only bring you more back pain through improper healing as muscles contract in response to an injury, continuing the cycle of pain. Laying down only makes them tighten more.
Just like a buildup of potential energy, this will cause you even more pain when you do eventually move again. So whilst you must clearly avoid certain exercise during acute or chronic episodes of pain, consult with your physiotherapist or chiropractor to develop a safe stretching and strengthening program to heal and protect your back as it is important to maintain your normal level of daily activity and continue exercising .
If you simply are not active, your body quickly becomes atrophied/de-conditioned, stiff or worse, frozen. (see: Frozen Shoulder Syndrome)

Myth #3: Shedding Pounds Will Not Affect Your Pain

Should one be overweight, it is important to understand that more weight equals more pressure on important joins in the body such as your knees, and affects your back quite measurably
“Dropping a few extra pounds can really help improve joint pain in the knees and hips,” says Patience White, MD, vice president of public health at the Arthritis Foundation. “Even 10 pounds can make a huge difference.”
Losing weight also can help back pain caused by muscle fatigue. Again, consult with your physiotherapy provider to understand how your muscles are out of balance and what needs to be treated to achieve balance.

Myth #4: Painful Flares Cannot Be Curbed By Exercise

Pain makes it harder to exercise. Harder, but not impossible, and certainly not inadvisable. Remaining active is on the top of the list for things to help you get better and feel better. Exercise will help you lose weight, maintain better sleep cycles, assist with digestion, boost your mood and help your brain and heart.
All of these will assist with reducing pain. Exercise clearly strengthen muscles, restores coordination and balance, and eases joint stiffness. Exercises such as swimming, walking and stretching, are excellent, low impact places to start. Your physiotherapy provider knows best about when and how fast to progress back as close to 100% as possible.

Myth #5: No Source? No Pain! Your Imagination At Work

“Just because you can’t find the exact origin of one’s pain doesn’t mean it’s not felt,” says John D, MD., a Washington, D.C. pain specialist. There is no true test for pain intensity, imaging is unable to display a representation of pain, and there is no instrument to assist with direct pain localization (taking into account things like, your finger, or a needle). Pleasantly, this does not mean pain is non-treatable.

Myth #6: Don’t Sweat The Small Pain

It is common believe that pain is something one must bear and be burdened with for the rest of their life. When pain, just by extension of functionality is something that should never be ignored. Pain is the body’s way of telling you that you are in danger and you need to pay attention or be damaged.
Should your pain recede during the use of over-the-counter pain medications, see your doctor if the pain persists for more than a week, worsens with time, or interferes with daily routine and activities.

Myth #7: Pain Is Unaffected By Attitude

If there is one way to increase pain, sour your spirits, and feel depressed: It is to dwell on that pain. “Those who focus on their pain tend to do poorly compared with those who have a proactive attitude and try to find ways to cope with their pain,” says Mr. Roger C, MD, associate professor of medicine at Oregon Health and Science University. Pain can certainly lead to, or be accompanied by depression and anxiety, making that pain worse. Speak with your Doctor, physiotherapy Provider, or Personal Therapist today to help ease your mind/body and get back to healing.

Myth #8: “No Pain, No Gain”

Remember everyone, we have said it before and we will say it again. Pain is the brain and body’s way of telling you how important it is you pay attention to what is happening before you damage yourself.
So, whilst it is understandable to push yourself to the point of “feeling the burn” during an exercise, it is very important to understand when you really should stop. If something hurts the wrong way and you do not notice, then those “extra reps” are creating damage, not benefit. Pain is reminding you that something is not correct. You should never feel pain when exercising. If you do, stop and take a break. To stay safe, learn what your limits are, and stay within them as you maintain or increase your routine.

Myth #9: Pain Just Comes With Age

The average ache here and pain there is a part of almost everyone’s life. It’s rather alike to wrinkles and gray hair. However chronic pain, with its ability to decrease quality of life and increase suffering and depression, is a real bugger, however it does not have to be. Most people should be able to lead relatively pain-free lives as they age. If you are bothered by chronic pain, your doctor, physiotherapy provider or pain specialist can help you find relief, no matter how old you are.

Myth #10: Pain Killers Cause Addiction

It is well understood and documented how most pain killers, opiates, and the like affect the human body and the patient as a whole. So if one truly takes their medication as directed, prescription pain medications rarely cause addiction. However, as with many drugs, your body can become physically dependent on pain medication. This does not imply that you are addicted, simply that if you stop using the mediation, you may have withdrawal symptoms should the use of that particular drug stop abruptly. This is an expected response when a prescription pain drug is used for more than a few days.
Your doctor or pharmacist can help you stop safely and more comfortably.

Myth #11: Pain Is A Head Game

Pain is a complex problem, involving both the mind and the body.
For instance, it could be said that back pain has no known cause in a fair number of cases, yet stressful life events will worsen its impact. This does not mean it is not real. Pain is an invisible problem that others can’t see, but that doesn’t mean it’s all in your head. A highly trained specialist or physiotherapy provider can greatly assist you in rooting out the real cause of your pain. For Example: Improper or misaligned walking gaits can and do cause back pain and more.

Myth #12: Only Sissies Go To Doctors: Complaining About Pain Makes You Weak.

There is no weakness in seeking treatment. It is understandable how those with chronic issues feel helpless and trapped by their pain, do not wish to burden others with their problems. The aged adult is far more likely to just push through the pain and its accompaniments, than their kids or grandkids are. We have all partaken in sports or activities which have required us to endure the occasional minor injury or headache, and that is one that. However, simply enduring pain of the chronic nature will impair function and impact quality of life. This is not a guessing game, it’s a fact. Fatigue from loss of sleep, anxiousness, trouble focusing or working, relationship impairment: Depression.

The fact is, you do not need to suffer, relief may be just around the corner.
You owe it to yourself to visit your physiotherapist or doctor to discuss how your pain can be treated effectively, the way it should be, and can be.

Myth #13: There is always an underlying cause when it comes to chronic pain

It is not always possible to link chronic pain to an injury or physical condition. Yes that minor car accident  a while back may have been a catalyst for your back pain. Perhaps too many hours on an improperly setup bicycle or running along the tarmac has caused you knee pain.
Or maybe not.
Pain can be a lone traveler, developing for no identifiable reason. Yet it’s indisputable the pain is very real.  It can be more difficult to relieve pain without a direct cause to treat, however you can still effectively manage it. This brings us to our next myth.

Myth #14: Something you did at one time caused your back pain

Jerking your body, lifting something heavy or improperly, slipping, falling are all potential culprits.
The lesser known disk degeneration from small micro-tears that go unnoticed over time could be the real cause of your back pain. The small jelly-like donuts sandwiched between the vertebrae of your spine are made up mostly of collagen and water and help your spine move. A “slipped” or herniated disk will cause inflammation and pain as it bulges out and presses on a nearby nerve root. Should a disk rupture, fluid is leaked, placing pressure on sensitive nerve endings in the lower back. 

Myth #15: Back-Extensions And Sit-Ups To Strengthen Your Core

For some of you it may come as a big surprise that traditional core exercises like crunches, back extensions and sit-ups are among the worst exercises as they can do more damage than good.
These exercises exacerbate an existing problem or cause a new one to occur as they are putting tremendous pressure on your disks. Ideal exercises for your core involve keeping your spine in a neutral position. Brace your abdominals as you would before a cough or clearing your throat, this will give you the best foundation to help keep your spine stable in everyday life. Try to not stick out your abdominal muscles or suck them in.

Myth #16: You Should Bend Your Knees When You Lift Something Heavy

“Proper lifting mechanics require you to actually lift with the hips, not with the knees, otherwise you will just end up with knee arthritis,” says Stuart McGill, University of Waterloo  professor of spine biomechanics and chair of the department of kinesiology.
If engaged in heavy lifting, endeavor as best as possible to disperse the weight throughout all of the muscles in your body, remembering to brace your abdominals as if you were going to clear your throat or cough, lift from the hips and keep the object close to you. When picking up a small item, bend from your hips, keeping your back straight using one leg out behind you for balance.

Myth #17: Increasing Flexibility Will Protect Your Back

“Statistically, those who have more range of motion in their back have a greater risk of back disorders in the future, so having a flexible back is not protective, in fact, it’s the opposite,” says Stuart McGill, University of Waterloo  professor of spine biomechanics and chair of the department of kinesiology.
The structure of the spine and skeletal muscles are designed to provide stability whereas leg and arm muscles are more movement oriented.

Myth #18: A Back Belt Is A Prudent Measure When Lifting Something Heavy

Those Belts you sometimes see airline baggage handlers, warehouses workers and weight lifters, do not reduce back injuries. According to the U.S. National Institute of Occupational Safety and Health (NIOSH) there is no supportive scientific evidence that supports claims of back belts lessening load on the spine or reduction of injuries. Fact: they may actually cause more harm than do good due to providing a false sense of support and security.

Myth #19: People Who Have Seen Several Physicians and Have Not Made Strides In Dealing With Their Chronic Pain Will Just Have To Live With It

There are few exceptions to the fact that there is no need for anybody to live with unbearable pain.
Available to you, are a wide variety of options for treatment, however it is necessary to locate the correct doctor or physiotherapy practitioner. Just as a cardiologist would be sought out for heart disease, or an ophthalmologist for vision issues, there are highly trained pain management specialists who deal solely in chronic pain. They are careful listeners who perform exacting physical examinations and treatments and who will not hesitate to combine care with other specialized medical consultants in developing a comprehensive treatment and longevity plan.

Myth #20: Pain Is Unaffected By The Elements

Sometimes common knowledge, but worth a mention anyways.
Should your joint pain change with the weather, it is definitely not your imagination at work.
Despite studies demonstrating mixed results, barometric pressure fluctuations cause some of those with arthritis to have increased join pain. Experts believe the barometric pressure change also affects pressure in the joints.

Dry Needling Explained

berold Acupuncture, Dry Needling, News and Events, Physiotherapy, Rehabilitation Comments Off on Dry Needling Explained

Dry Needling Explained

Dry Needling, By: Reza Ghannadan, MPT, BSc (Kin), Physiotherapist

Every physiotherapist has an “Ah-ha” moment in their career. This is the moment when they have an insight or realization that will change the way they assess and treat patients.

I recently had this “Ah-ha” moment after completing my first two Functional Dry Needling courses through Kinetacore this past January, 2014. Functional Dry Needling is an effective technique and has altered the way I assess and treat my patients. So, you may be wondering what Functional Dry Needling is.



What is Dry Needling?

Dry Needling, also known as Intramuscular Stimulation (IMS), is an effective technique used by physiotherapists to treat pain arising from muscles and/or nerves. Dry needling involves inserting a needle, without medication or injection, into an area of the muscle known as a trigger point.

A trigger point is an irritable, hard “knot” within a muscle that is painful when palpated and can produce significant pain over a large area. Trigger points are very common and can often make everyday tasks difficult. Often, these trigger points may be too deep to be effectively treated by other treatment techniques.

How does Dry Needling work?

Dry needling works by advancing the needle into the trigger point, which causes the muscle to grab onto the needle in an attempt to repel the needle. This is called a localized twitch response. This localized twitch response is necessary in order to deactivate the trigger point and relax the muscle. This can result in significant pain relief, decrease muscle tension, increase the range of motion, and promote a return to activity.

What can I expect to feel with Dry Needling?

Many people may not feel the needle insert into the skin. However, once a localized twitch response is elicited, the discomfort can vary drastically. Many people describe the feeling as a muscle cramp once a localized twitch response is elicited. People will soon learn to recognize and even welcome the sensation, as deactivating the trigger point reduce decrease pain, restore muscle length and improve function.

What conditions can Dry Needling treat?

A broad range of musculoskeletal injuries can be treated effectively with dry needling. These include, but are not limited to, the following:
   •    Shin splints
   •    Plantar Fasciitis
   •    Low back pain
   •    Sciatica and piriformis syndrome
   •    Knee pain and Patellofemoral pain syndrome
   •    Neck pain and whiplash symptoms
   •    Headaches
   •    Tennis and Golfer’s elbow
   •    Shoulder pain
   •    Repetitive overuse injuries
   •    Chronic pain

Who will benefit from Dry Needling?

Prior to treatment, your physiotherapist will first perform a thorough assessment to determine if you may benefit from Dry Needling. If you are a good candidate, sessions will vary from 1-2 times/week. Your physiotherapist may also incorporate other forms of therapy, such as manual therapy or exercise, as part of your treatment. The total number of treatment sessions will vary depending on a number of factors, including the cause and duration of the symptoms, your general health, and you and your practitioner’s satisfaction with the outcome.

How is Dry Needling different from Acupuncture?

Dry needling is different from Traditional Chinese Acupuncture. Both methods do involve inserting a needle into the tissue. However, there are significant differences in the evaluation, application and overall goal of the treatment. Traditional Chinese Acupuncture involves inserting needles along a meridian based on Eastern Medicine principles in order to re-establish chi, or life energy, back in the body. Dry needling involves an examination of the neuromuscular system and insertion of a needle directly into hyperirritable spots within the muscle in order to de-activate it, and thus, decrease pain and restore function.

Is there research evidence supporting Dry Needling?

Yes. A recent, high quality review of several studies found dry needling can be effective in providing immediate pain relief after treatment and at 4 weeks post treatment in patients with upper body muscle pain1. There has not been enough research evidence to determine its effectiveness on lower body conditions. However, your physiotherapist can still help treat many lower body injuries with dry needling. Please consult with your physiotherapist.

Take-Home Message

Dry Needling is a powerful and effective treatment adjunct used to treat many musculoskeletal conditions. Your physiotherapist will perform a thorough assessment to determine if you will benefit from Dry Needling.

If you think you would benefit from Functional Dry Needling or if you have more questions about it, please book an appointment with Reza by calling 604-987-5291.

About me: Reza Ghannadan is a Physiotherapist and is certified in Functional Dry Needling through Kinetacore.

1. Kietrys, D. M., Palombora, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., & Tucker, M. (2013). Effectiveness of dry needling for upper-quarter myofascial pain : a systematic review and meta-analysis. Journal of Orthopaedic Sports and Physical Therapy, 43(9), 620-634.

Common Running Injuries

berold Fitness, Injury Prevention, Physiotherapy, Rehabilitation Comments Off on Common Running Injuries

Common Running Injuries

By: Reza Ghannadan, MPT, BSc (Kin), Physiotherapist

Common Running Injuries

Common Running Injuries

I recently volunteered at the Mountain Equipment Co-op (MEC) Vancouver Race Series 5k/10k in Stanley Park. Myself and a massage therapist were onsite to provide post-race treatment for runners.

What surprised me was how many runners required post-race treatment for common running injuries, to manage their pain and other symptoms. Several runners had never been to a physiotherapist before and were not aware as to the cause of their pain or how to manage it. This is where physiotherapy can help as demonstrated by the fact that the majority of runners achieved significant pain relief of their common running injury within a 5-7 minute treatment session.

Below is a list of common running injuries physiotherapy can address:
1. Iliotibial Band Friction Syndrome (AKA outer thigh pain)
2. Patello-Femoral Pain Syndrome (AKA central knee pain)
3. Hamstring strain
4. Shin splints (AKA inner or outer shin pain)
5. Plantar Fasciitis
6. Achilles Tendinitis

In order to manage your common running injury, your physiotherapist will initially perform a thorough assessment in order to identify the structure(s) at fault. Then, an individualized treatment plan will be developed to address your specific needs.

Muscle imbalances are usually a key feature in the above injuries. Your physiotherapist may “release” or stretch tight muscles and strengthen weaker muscles in order to correct these imbalances. For example, in Patello-Femoral Pain Syndrome, your physiotherapist may release your tight quadriceps and iliotibial band (outer thigh), and strengthen the gluteal muscles. This will help correct muscle imbalances and promote return-to-activity. Your physiotherapist may also incorporate other modalities to promote recovery, such as dry needling/acupuncture, taping, electrotherapy, and education regarding activities/positions to temporarily avoid.

Personally, I have successfully helped manage the above common running injuries in a variety of populations, whether sedentary, active and athletic. What I have learned is that every patient is different and thus requires an individualized treatment plan to achieve their fitness goals. Healing timelines will vary depending on how acute or chronic the injury is, your age, your activity levels, and your compliance with the treatment plan.

Bottom Line: Common running injuries are very common and the majority of runners may not be aware how to manage them. A physiotherapy assessment can help identify the cause of your pain and your physiotherapist will develop a treatment plan to manage your injury and keep you active.

If you are experiencing any of the above injuries, physiotherapy can help. Please contact us at 604-987-5291.

About me: Reza Ghannadan, MPT, BSc (Kin), Physiotherapist – certified in Functional Dry Needling through Kinetacore.
Common Running Injuries