What’s causing the pain? How do I alleviate the pain for good? These questions from our patients has led the profession down a new route. A route that no longer looks at just the source of pain, but also the cause of pain. It has led us to a new concept, dubbed “regional interdependence“.
In short, regional interdependence is looking at the whole body to better understand the cause of one’s pain location. As you can imagine, the education and treatment of a person will be quite different when focusing on the body as a whole rather than having tunnel vision solely on the area of discomfort. No longer are the days where physical therapists simply identify the source of discomfort and apply direct interventions solely to the source of pain. The profession has realized that the majority of our patients are not looking for the quick cure, but rather the long term answer. The latest from the profession has suggested intervening at the thoracic spine for pain located at the cervical spine, treating the hip for individuals suffering from low back pain, even interventions focused on the brain and understanding pain for treatments of chronic pain.
A piece of research that I was lucky enough to take part in during my Spine Rehabilitation Fellowship offers a new paradigm on the potential treatment of chronic neck pain. The research was part of a platform presentation at the 2014 APTA Combined Section Meeting in Las Vegas, and (keep your fingers crossed) will be available after it is published shortly.
The study may be the initial step to eventually show a potential relationship between trunk stability and chronic neck pain, offering a new approach for the treatment of chronic neck pain. A quick synopsis of the rationale:
Moseley showed that individuals with sub-acute neck pain also have impaired trunk muscle function.
This study showed a difference in the deep neck flexor endurance test exists between individuals with and without chronic neck pain.
This begs the question, will trunk stabilization improve the endurance time during the deep neck flexor test, therefore improving the endurance deficit that may be the cause of discomfort for individuals with chronic neck pain? The initial study shows that there is a difference in endurance time when an individual is given manual bracing at the trunk. Of course, there are several more steps needed before trunk stabilization exercises are prescribed for individuals with chronic neck pain.
A basic summary of the research: trunk stability may play a big role in the long term treatment of chronic neck pain. No longer are the days of simply looking at the location of pain for treatment (cervical spine), but rather towards the whole body for the cause of pain (trunk stability). The physical therapy profession is ever changing, and with some more research the new paradigm for treatment of individuals with chronic neck pain may include trunk stabilization.
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