Patient Question Friday: Does _______ Work?

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This isn’t one question I get from any particular person. Its a form of a question I get from almost every person. Does something work for my problem? The something can be a wide variety of options medications, surgery, creams or rubs, braces, straps, ice, heat, massage, acupuncture, taping, and others.

There are a couple of layers to this question. The first is what does the person mean by works? Do you mean fix my problem? Or more along the lines of will it help my pain to some extent? What I think some people mean is am I going to be spending my time and money wisely to try this.

The truth is the answer to the first question is frequently, no its not going to fix your problem. The body will fix most problems by healing. We can help that along with proper management of the injury. Rest when needed. Protect what needs protecting. Restoring movement, strength, and function at an appropriate level. Time is a factor. Now some of those techniques and products may help in that situation. Taping or bracing may protect something for example.

The answer to the second question, will it help my pain to some extent?, is usually maybe, or it might, or it could. But, everyone is different and we never know for sure. So, does that mean you should try these things?

I like to ask a few questions when assessing whether a technique or product could be useful.

  1. Is it scientifically plausible?
  2. Can it be harmful?
  3. Is it affordable for you?

The 1st question is probably the most important. There are many things out there that just make no sense from a scientific perspective. But, some people swear by them. Why is that? Its also sometimes difficult as a consumer to ferret out the evidence. Testimonials in ads are powerful and we don’t really have time or access to do research. The first thing to know is many products “work” in the sense of reducing pain. The issue is sometimes the scientific reasoning is backfilled in after someone discovers something helps pain. They design a new product or technique. They want to market it. They know it needs an explanation to convince people. So they come up with a seemingly plausible reason that it might work, it puts you back in alignment, it changes blood flow, it releases energy. They usually don’t have much science behind it.

There are some reasons that many things “work” in many people. And there is science behind it. Pain from tissues is driven by your nervous system as a protective response. You have an injury and nerve endings send signals detecting mechanical stress, temperature, or inflammation up to the brain. The brain processes these signals and determines what to do. This can be pain. Many of the things I listed above alter the signals the nerve endings send up to your brain. Heat and ice affect temperature. Manual therapies and taping affect mechanical stresses. If we get a different input from the nerve endings, we can get a different out put from the brain. We may experience less pain. We aren’t really changing the tissues, we are influencing the nervous system.

Two other plausible reasons things “work” from a scientific reason are treatment alliance and placebo/treatment effect. Treatment alliance has to do with your relationship to the person giving you advice or helping you. We know that if you have confidence and trust in the person you are getting advice from or working with you will have an improved response. Placebo and treatment effect also play a part. Knowing we are doing something has a powerful effect on our nervous system. Even if the treatment isn’t doing a lot biologically, it can affect pain perception and biological systems.

So if we determine that there frequently is at least some plausibility, what should we do? I then assess the nest 2 questions safety and cost. If we know something is really safe and very affordable. There is no reason not to give it a go. Most conservative things are pretty safe. Many are free to try at home or minimal cost. Go for it. It may give you relief, it may not. But no harm done. Things like surgeries or other major procedures are where the questions come in. Their is a lot more risk when we get involved with these. That’s when we really need to focus on why someone is having pain, and if these procedures really will “work”.

If you have questions about something, post in the comments or call us at 970-949-9966 or ascent-pt.com

 

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