The Complete Guide to Soft Tissue Pain Therapy
Patients seek your specialized knowledge and training to help relieve their pain.
Depending on your diagnosis, you may use a combination of adjustments and supplements to make your patients feel better. Your tools may also include a variety of topical analgesics and other soft tissue pain therapy options, which you apply during your client’s visit and that you might send home with them.
It’s time to explore the ins and outs of these soft tissue pain therapy treatments as there appear to be new ones arriving almost daily.
The Gate Theory of Pain
As Spine-health explains, the gate control theory of pain contends that, when an injury occurs, pain messages don’t just travel from the nerves to the brain. Instead, there are “nerve gates” that control how much of the message will make it through, ultimately impacting the intensity of the pain felt. Furthermore, with the right intervention, the messages may not make it through at all.
Developed by Ronald Melzack and Patrick Wall in the early 1960s, the gate control theory relies on two fibers within the peripheral nervous system: A-delta fibers and C-fibers. The A-delta fibers are “fast” fibers, or fibers that are capable of delivering pain messages at the rate of 40 miles per hour (mph). C-fibers on the other hand are much slower, only traveling 3 mph, making them more responsible for continual-types of pain.
Under this theory, you can potentially avoid pain by overriding these fibers, essentially closing the gate so they can’t fit through. This is at least partially why treatments related to massage, acupuncture, and transcutaneous nerve stimulation are so effective, because this is what they do. It’s also the reason that topical analgesics work to decrease pain as well.
Research has substantiated that it is the active ingredients in these topicals that makes them so effective. For example, one study published in the International Journal of Sports Physical Therapy found that a topical containing 3.5 percent menthol was more effective at decreasing discomfort than applying ice to the pained area. Another piece of research, this one published in Phytotherapy Research, reported that topicals with capsaicin provide more relief for chronic back pain sufferers than placebo treatments.
Research has also supported the notion that joint and musculature injuries typically respond well to topical use. According to an overview of 13 reviews which was published in the Cochrane Database of Systematic Reviews, some of the conditions that topicals help treat include sprains, strains, osteoarthritis, and neuropathic pain.A prescription usually isn’t necessary to buy many of the topicals on the market today, though there are some that do require a doctor’s order. For example, the National Eczema Association reports that topicals containing corticosteroids require a doctor’s permission. Perhaps this ease of access partially explains why use of these analgesics is on the rise.
Using topical analgesics
You are the expert at diagnosing and treating your patients. During your treatment, you may find that permanent pain relief will take some time for your patient. In the meantime, you want to provide him or her with an analgesic that reduces the pain without causing the side effects of an ingested product. In this situation, you can apply an analgesic to the painful area after performing an adjustment.
Ask patients how the analgesic feels and if the pain seems less intense. Also, observe patients to make sure they are not having an adverse reaction.
Because there are cooling analgesics containing only menthol, as well as warming analgesics containing menthol and other ingredients including capsaicin, you may be unsure of which product to apply.
Generally, patients with chronic pain, such as arthritis and lumbago, feel relief from warming products, though some chronic pain patients only get relief from cooling products.
Cooling topicals work well with an acute injury. You may want to experiment so that you get to know the kinds of conditions that each treats best.
Warning: Do not use warming technology or hot towels on patients after applying a topical analgesic. Ultrasound and other heating or hot applications can lead to blistering and burning if used with topical analgesics.