WHAT SHOULD I EXPECT AFTER MUSCULOSKELETAL TREATMENT?
I have had mobilisation of my spine.
Gentle mobilisation of the spine can often give immediate relief from the pain and restricted motion due to vertebral segmental (spinal joint and muscle) dysfunction. This is not usually associated with any flare of pain. Follow-up exercises are usually required.
I have had manipulation of my spine (a firm, very short, quick movement of a joint)
When mobilisation is not helping enough Dr Creswick may use manipulation. He does not use manipulation in the neck. Sometimes when manipulation is used some minor flare of discomfort can be experienced over the remainder of that day and overnight. This usually then settles.
In the neck, Dr Creswick uses gentle mobilisation, never manipulation. The reason for this is to avoid the rare but recognised complications of manipulation of the neck, such as stroke.
What is a trigger point injection and what should I expect after one?
Trigger points are tender “knots” in muscles which radiate pain. Dr Creswick usually uses a weak solution of local anaesthetic to treat trigger points. He does not use cortisone injections into trigger points because this can sometimes cause a local toxic effect on the muscle at the point of injection. Trigger point injections are usually immediately painful as the needle hits a tender point in the muscle. Then pain is reduced as the local anaesthetic takes effect. This stretches the fibres and allows muscle stretching. The local pain relieving effect of the local anaesthetic usually only lasts 20 to 30 minutes. Then there can be of a flare of pain although this is usually mild. This flare of pain usually lasts 48 hours. Then significant pain relief from the initial presenting pain is expected.
What should I do after a trigger point injection?
Stretching exercises are important. Gentle stretching is very helpful to maintain improvements. The gentle stretching exercises in which you have been instructed should be applied twice a day. Avoid discomfort. Then, after stretching, gentle heat should be applied for 10 minutes over the painful muscle. Liniments should never be applied to the skin before the application of heat, as some can be toxic to skin.
What does it mean if pain goes away and then returns?
If pain responds significantly to specific physical medicine treatment that you have had, it usually means that the diagnosis of the problem is correct. If pain returns, try not to lose heart as further treatment by the doctor and home exercises should give increasingly lasting results.
How do I stop my pain from coming back in the future?
Carefully applying your exercises in which you have been instructed for several weeks can be very helpful and may be all that is required. Usually except with very recent problems, further treatment one to two weeks later is needed. With very established problems, instruction in postural exercises may be required. These may require coordination of your breathing pattern to help postural muscle control. Dr Creswick can instruct patients in exercises to aid posture and help prevent musculoskeletal pain in the future.