Thursday Thoughts: Another Way to Distract and Dissociate Pain | Modern Manual Therapy Blog

Thursday Thoughts: Another Way to Distract and Dissociate Pain


We tend to think of terms like distraction and dissociation for movement. Distraction being separating two joint surfaces, and dissociation isolating one body part from another in a controlled manner.

I have come to look at both of these terms in terms of threat mitigation. Distraction is a powerful mediator for pain. A skillfully, well explained, and non-threatening input like IASTM, joint mobilization, PNF, etc may dissociate the perceived threat or stretch perception associated with a movement.

Recently, I saw a case of acute and very painful unilateral left cervical pain. While she met the Upper Quarter Clinical Practice Patterns I go over on The OMPT Channel and The Eclectic Approach to UQ Assessment and Treatment, loading the movement only temporarily relieved her pain.
She could not load with regularity, despite IASTM, PNF and other attempts to decrease the discomfort during cervical retraction and SB left - her directional preference. It is entirely possible through repeated exposure over several days, her pain levels and motion would both improve, but why wait if another option is available?



In the past, this patient responded to IASTM and PNF, perhaps these interventions were not so novel to her nervous system or those inputs were threatening. Instead, I used Khalili Cream and some kinesiotape along her left cervical spine and upper trap. The combination of cool/warm feeling of the cream plus input from tape enabled her to load to end range repeatedly throughout the day. In two days, she was pain free and back to full function.

Would this have happened without the tape and Khalili Cream? Probably, and eventually yes, but similar to what I say manual therapy is for, the inputs that worked were just cheats to get someone compliant with the home program that kept her better.
Keeping it Eclectic...

0 comments:

Post a Comment