The Joy of Pain and Toil


As usual, I am thinking about pain and my patients today.  Since it is the week of Easter I thought I would look for some inspiration in the scripture.  This is what I found:

Psalm 90: 9-10

All our days pass away under your wrath; we finish our years with a moan. Our days may come to seventy years, or eighty, if our strength endures; yet the best of them are but trouble and sorrow, for they quickly pass, and we fly away.

A bit grim…

However, I think there is actually a message of hope here for people suffering from chronic pain.  Continue reading


The New Normal


We see patients in pain every day, and most of these people are coming to physical therapy for the sole reason of eliminating pain. For some it is easier than others, but often I will talk with patients about “getting back to normal.” Or sometimes a patient asks me: “Is this normal?” or “What is normal?”

Interesting question. Continue reading

Joint Replacements, Phantom Limbs and Warning Lights

I work with chronic pain patients quite a bit in the clinic. Using modern neuroscience education and graded motor imagery we are able to cure pain conditions that have been classified as untreatable. I have written previous posts on these topics here and here, and would encourage you to check that out if you are not familiar. Although I like working with chronic pain patients, the majority of people I see are orthopedic patients (knee, back, shoulder etc.).

One particular gentleman came to me a few months ago after undergoing a total knee replacement. His rehabilitation has progressed very well. He has full range of motion and strength, and is back to doing most of his normal activities. However, he has had some lingering pain that continues to limit him. Continue reading

Laughter May Really be the Best Medicine (From 9/12/14)

We have all heard the expression, “laughter is the best medicine.” When I hear this I immediately think of the movie Patch Adams, which is about a physician who works to help children heal, and cope with illness by dressing up as clown, telling jokes, and performing other antics. If you haven’t seen it you can download it from Redbox Instant Video or Vudu. However, I think that “laughter is the best medicine,” is a bold claim. Is there any evidence to suggest that this is true? Continue reading

The Perfect Ten…Point Pain Scale (From 6/16/14)

Of all the questions that we as physical therapists ask our patients, the one I find the most interesting is:
“Can you rate your pain on a scale of one to ten, with one being the least amount of pain, and ten being the most?”

I don’t think there are any clinicians that really love this method of assessing pain. After nearly one hundred years of modern medicine, no one has come up with anything better, but we have come up with lots of variations.

Numeric Pain Rating Scale

Faces Pain Rating Scale

All of these scales attempt to approach the same issue from different angles, but all of them confuse patients and clinicians alike.  Below are some of the answers that I have heard from both patients and clinicians, and all of them demonstrate just how confusing the pain scale can be. Continue reading

Catching the Deadliest Advice (From 5/30/14)

I LOVE the show Deadliest Catch. I absolutely cannot get enough of it. If you have never seen the program, it is about 6 or so boats that travel the Bering Sea fishing for various types of crab. The show is now in its tenth season, and I still like it just as much as I did in the beginning. The arctic environment the fishermen work in is extremely harsh, and there are often injuries on the boats. Broken fingers, sprained joints, bruises, cuts, and back pain are just a few of the common maladies suffered on the show.

However, I was watching last night and one particular injury caught my attention. Scott Campbell, Jr., the captain of the Seabrook, has been suffering from severe low back pain for most of the king crab season. Last night his condition finally got the best of him, and he was forced to leave his boat to seek medical attention. Continue reading