Chronic pain is a debilitating condition affecting the quality of life of many of your patients. When patients experience chronic pain they feel physical symptoms that prevent them from leading a happy and healthy life. These painful patterns can affect your patients physically for months and even years. Many patients will also experience depressive mental health symptoms associated with prolonged pain.
Chronic pain is defined as “A continuous, long-term pain of more than 12 weeks or after the time that healing would have been thought to have occurred in pain after trauma or surgery. There are a number of different pain syndromes, ranging from neuropathic pain to inflammatory pain” (Surah & Baranidharan, 2014).
The effects of pain can be dramatic for your patients. Patients are so desperate to be out of chronic pain that painful conditions are the most common complaint for patients in outpatient clinics (Surah & Baranidharan, 2014). From a public health perspective the impact of chronic pain is a tremendous burden.
The Chronic Pain Impact
- 5 billion people worldwide suffer from chronic pain (The American Academy of Pain Medicine)
- 3 million people suffer from pain everyday (National Health Interview Survey)
- Pain costs society at least $560-$635 billion annually, an amount equal to about $2,000.00 for everyone living in the U.S. (The American Academy of Pain Medicine)
- 40-60% of patients who experience chronic pain also develop depression (Surah & Baranidharan, 2014)
The Role of Postural Correction in Reducing Symptoms of Chronic Pain
You can help your patients overcome chronic pain by understanding the root causes of their condition. For many patients who are suffering from neck pain, headaches, and carpal tunnel syndrome their condition is caused from poor structural alignment and worsened overtime with poor ergonomic conditions in the workplace.
Posture is the structural framework of the body. Helping your patients achieve proper posture can help them reduce symptoms associated with chronic pain. Good posture is associated with increased mobility, better range of motion, and less damage to the joints. Multifactorial postural correction is necessary to achieve long-term postural correction results including structural alignment treatments, posture rehabilitation, and proper ergonomic conditions that support good posture in the workplace.
Neck Pain and Forward Head Posture
Neck pain is a common form of chronic pain. Many patients will say that their neck hurts after work, or they feel pain and tightness in their neck and shoulders. One solution to the reduction of neck pain is to correct postural distortion patterns such as forward head posture.
Forward head posture is classified as a reduction of the craniovertebral angle. You can observe forward head posture with your patients by determining if the patient’s ears are anterior to their shoulders on a Posture Image. Forward head posture is common among computer workers.
The Craniovertebral angle in subjects with neck pain is significantly smaller than that in normal subjects. Patients with small craniovertebral angle have a greater forward head posture, and the greater the forward head posture, the greater the neck pain disability (Yip et al., 2008).
According to Silva et al. (2009) younger patients with chronic non-traumatic neck pain were shown to have a more forward head posture in standing than matched pain-free participants.
Headaches and Head Posture Distortion Patterns
Headaches are a common condition among patients resulting in chronic pain. Headaches can be caused by many different factors, one of which is head posture distortion patterns. When patients present with poor head and neck posture, they will commonly experience headaches.
Researchers concluded that patients suffering from migraines showed a smaller craniovertebral angle than control patients who did not have migraines, thus presenting with greater forward head posture (Fernandez-de-las-Penas, Cuadrado, & Pareja, 2006). The researchers also showed that for patients suffering from chronic tension type headaches, the frequency for which they experienced headaches was greater when the patients had forward head posture (Fernandez-de-las-Penas, Blanco, Cuadrado, & Pareja, 2006).
When comparing patients suffering from cervical headaches to the non-headaches group, it was demonstrated that the cervical headache group had greater forward head posture, less isometric strength, and less muscle endurance (Watson & Trott, 1993).
Carpal Tunnel Syndrome and Forward Head Posture
Carpal tunnel syndrome is a painful condition that is becoming more common among computer workers. Carpal tunnel syndrome results from chronic compression of the median nerve at the carpal tunnel of the wrist. Patients suffer from pain, discomfort, and tingling among the Median Nerve distribution.
Poor posture and positions assumed at home, at work, and during sleep can directly increase pressure on nerves at entrapment sites, thus resulting in painful conditions such as carpal tunnel syndrome (Novak & Mackinnon, 1997).
Researchers found that patients with mild to moderate carpal tunnel syndrome exhibited a greater forward head posture and less cervical range of motion, as compared to healthy controls. Additionally, a greater forward head posture was associated with a reduction in cervical range of motion (Rincon, Palacios-Cena, Fernandes-de-las-penas, & Cleland, 2009).
Chronic Pain Patients are Complex
Chronic pain patients are complex patients. Their pain is likely due to multifactorial causes, and chronic pain patients commonly have depression in addition to their physical symptoms.
Many chronic pain patients have lost hope and feel depressed. When addressing chronic pain with your patients it is important to consider the mental health component as well. Have a conversation with them about what it will take to get out of pain, and how staying positive and motivated will help them achieve their desired results.
Postural correction is a natural solution to help reduce symptoms associated with chronic pain for patients suffering from neck pain, headaches, and carpal tunnel syndrome. By focusing on postural correction you can help your patients reduce pain and achieve a better quality of life.
American Academy of Pain Medicine, AAPM Facts and Figures on Pain. Retrieved from http://www.painmed.org/patientcenter/facts_on_pain.aspx.
Fernandez-de-las-Penas, C., Blanco, C., Cuadrado, M., & Pareja, J. (2006) Forward Head Posture and Neck Mobility in Chronic Tension-Type Headache. Cephalgia, 26(3).
Fernandez-de-las-Penas, C., Cuadrado, M., & Pareja, J. (2006) Myofascial trigger points, neck mobility and forward head posture in unilateral migraine. Cephalgia, 26(9) p. 1061-1070.
National Institute of Health (2015) NIH analysis shows Americans are in pain. Retrieved from https://www.nih.gov/news-events/news-releases/nih-analysis-shows-americans-are-pain.
Rincon, A., Palacios-Cena, D., Fernandes-de-las-penas, C, & Cleland, J. (2009) Increased Forward Head Posture and Restricted Cervical Range of Motion in Patients With Carpal Tunnel Syndrome. Journal of Orthopedic and Sports Physical Therapy, 39(9) p. 658-664.
Silva, A., Punt, D., Sharples, P., Vilas-Boas, J., &Johnson, M. (2009) Head Posture and Neck Pain of Chronic Nontraumatic Origin: A Comparison Between Patients and Pain-Free Persons. Archives of Physical Medicine and Rehabilitation, 90(4) p. 669-674.
Surah, A. & Baranidharan, G. (2014) Chronic Pain and Depression. Continuing Education in Anesthesia Criticall Care and Pain, 14(2) p. 85-89.
Watson, D. & Trott, P. (1993) Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia, 13 p. 272-284.
Yip, C. et al. (2008) The relationship between head posture and severity and disability of patients with neck pain. Manual Therapy, 13(2) p. 148-154.