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Posted by on Sep 12, 2016 | 0 comments

Treat The Cause, Not The Symptom

back-pain-bannerImagine if you will, that you want to buy a new car. You’ve worked hard, saved your money, and now, finally, you can buy that new car you have been looking at for months. The car is perfect. It has the right look, style, and color. All of it is just as you imagined it. You look great in it, which is the icing on the cake. And you can just imagine yourself driving around town, feeling good and looking good.

But wait. What you don’t know is that the tires aren’t aligned correctly.  You can’t tell from the way the car looks on the outside, but you know it means trouble for the life expectancy of the car.

So you ask yourself, Will the tires start showing abnormal wear?


Now you have a problem, because no one wants to deal with problematic tires. So the next question you ask yourself is, How soon will the tires start to show abnormal wear?

But this answer is harder to pin down. The truth is you don’t know exactly when you will have tire problems because it all depends on how much the car is driven. Driving one mile a day to and from work will have a much different outcome on the wheels than driving 60 miles a day.

So. You don’t know how fast the tires will wear out, but it is a foregone conclusion that they will wear out. So when this happens, what do you do? One option is to change the tires. The car looks good again, but did you really fix anything? Common sense says no. You supplied a temporary fix. You helped the symptoms but didn’t fix the problem long-term. If you got the tires realigned as well as changed the tires, then you took care of the symptoms but also fixed the cause of the problem in the first place. Better choice always.

What does all this car talk have to do with anything? Well, your body acts in much the same way. A big percentage of musculoskeletal pain is caused by overuse. The joint(s) and/or muscle(s) break down over time because of improper body alignment, otherwise known as poor movement mechanics. The end result is tissue breakdown and pain.

When this occurs, there are a lot of options at your disposal to help you. And you have a choice: you can either treat the symptoms in order to feel better, or you can treat the cause of the breakdown.

Let’s look at what happens when you treat the symptoms. You know the drill: you played a weekend game of basketball, and now your knee is swollen and tender. You might simply pop a pill – a prescription or over-the-counter pain pill or even a muscle relaxant. And maybe your knee feels better temporarily, but will the pain return? Possibly. Was anything corrected? No. The root cause of the pain is still there.

Massage is a great treatment. It can relax those tired achy muscles and make you feel like a million bucks. You’ll be calmer, more relaxed, and feeling good. You might even be pain free. But what about tomorrow? What happens if your pain comes back? Well, the cause of the stiff achy joint or muscle was not corrected, and it is just a matter of time before you feel its effects again. As great as massage is, it isn’t enough. In can be a helpful and comforting addition to other therapies, but massage alone won’t fix your problem. Similarly, ultrasound, electrical stimulation, topical creams, heat, ice, stretching, and rest can all be a useful part of a rehabilitation program. They help with pain relief on a temporary basis, but none of them used alone will correct the cause of poor mechanics.

My opinion is that too much is made of the above treatments. Commonly, they might be the only forms of treatment applied, whether alone or in combination, and when the patient feels better, he or she is released, and everyone – patient and therapist – believes the patient has been cured. Unfortunately, as I have witnessed many times at some point the symptoms return, and they are usually stronger and last longer. The patient is often confused and discouraged. In her mind, she hasn’t been doing anything differently. She just had the bad luck of bending over and having her back go out. Again.

The problem is that her back didn’t go out as a direct result of bending over that one time. It has been breaking down for a long time. She had been functioning with poor mechanics and, like we have seen, it is just a matter of time before the structure will break down. If the same symptom-relieving approach is taken, the results will end up being the same over time. And thus begins a vicious cycle: the patient feels better for a while, but then there is another breakdown so she needs more symptom relief, etc. Not coincidentally, back pain is the best predictor of future back pain, and back pain in particular usually gets more intense every time there is an episode.

I say, let’s treat the cause. Many people breakdown because of excessive sitting; poor sitting, standing, and lifting postures; and/or overuse on the athletic field. If the cause of your pain is addressed, the pain will go away, and, more importantly, you will actually give yourself a much better chance of not having a recurring problem. You corrected the mechanism of breakdown.

Does it make sense to sit at a desk all day and then with the best of intentions go workout in the gym only to find yourself sitting again on an exercise machine?

No. We need to exercise on our feet.

Standing requires 59% more muscle activity than sitting does, which is a big plus both from the perspectives of biomechanics and caloric burn.

Also consider: how many daily activities in the home, yard, or garden are performed sitting? Very few. We are on our feet for the majority of our functional activities. Train for it, but only with good body mechanics. Learn how to move correctly and safely. This will maximize results, protect your body from breaking down, increase body awareness, and help you move more efficiently; the list of benefits is long.

Another bonus is that the more you understand how to use your body, the better control you will have over it. No one wants to always have to run to the physician or therapist for every ache or pain. Learn to become your own body mechanic. It isn’t as hard as you think. Utilizing a few postural and mechanical rules, you can take charge of your body.

Does this guarantee you will never have a pain issue again? Unfortunately, no. That would be like saying that if you play on the sidewalk instead of the middle of the road, you will never get hit by a car. A car could jump the curve and hit you, but certainly your chances are much better on the sidewalk than in the middle of the street. And if you do have a setback, it will be easier on your own to correct it by following the body rules you have learned.

My rule of thumb is that a patient should feel as though he is making permanent progress within two weeks. If there isn’t any solid improvement in two weeks, it might be that we are doing the wrong thing or it might not be a problem that can be corrected with therapy.

Think about it. If all you can say is that you feel better for a few hours after a treatment, but then the pain returns at the same level as before, then you haven’t corrected or changed a thing. You aren’t healing; you are simply changing the tires. Since the problem isn’t fixed, it is not a matter of if you are going to break down again, It is only a matter of when. When dealing with musculoskeletal pain, make sure you are being treated by someone who is interested in figuring out the cause of the problem. Take as good of care of your body as you do of your car.