DEAR DOCTOR K: I'm still recovering from a neck injury, but I'm scheduled to begin rehabilitation exercises with a physical therapist next week. How can I start rehab when I'm in so much pain?
DEAR READER: Your question reminds me of the time I recommended rehabilitation exercises to a patient with knee pain. The patient responded: "So you're prescribing a little pain to get rid of my pain? Don't get mad at me, Doc, but I don't feel so good that I can afford to feel bad."
After a little explanation and persuasion, the patient agreed to the exercise program. Ultimately, he was glad he had done so.
Although it may be hard to believe, without active exercises it is hard to relieve pain, restore function and reduce the risk of reinjury in your neck.
If you're still in too much pain to perform rehab exercises, your physical therapist can do some "passive pain-relieving interventions" to ease your pain and get you ready for active rehab. These techniques are not a substitute for necessary exercises. Instead, they make it easier for you to do them.
-- THERAPEUTIC ULTRASOUND. Also called ultrasound diathermy, this treatment converts sound waves into heat that penetrates into deep tissues. The ultrasound is delivered through a wand rubbed gently over the affected area.
-- TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS). In this therapy, small adhesive electrodes are placed on your skin at or near the sites of your pain. The electrodes transmit a very low electrical current to underlying tissues. This current "distracts" your brain from paying attention to the pain messages coming from that part of your body.
TENS does not have a direct impact on the underlying cause of pain. But by relieving your symptoms, it may help you participate in your rehab program.