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Chronic Pain
Chronic pain patients are among the most misunderstood patients in our healthcare system, which is better equipped to deal with specific, acute pain processes. Healthcare providers often struggle to understand how to approach pain that is long-lasting, potentially widespread, and without clear causality. As a result, chronic pain patients have to become their own best detectives and advocates for their healthcare and well-being - a difficult task for someone who may be struggling to complete basic activities of daily living and maintain a reasonable quality of life.
We have direct, decades-long personal experience with family members who have gone through this process and found effective management tools. That toolbox will look different for each patient, and while we can't guarantee total resolution or a perfect explanation for your pain, we can provide tools to help give you more physical autonomy and functionality, we'll be dedicated to you for the long-haul, and we'll try to make your rehab a fun and supportive space.
What is chronic pain?
Technically, any pain that lasts longer than 3 months (and beyond the normal healing time for a given tissue) falls under the category of chronic pain. For some, there is a clear primary injury that instigates the pain, but through a variety of poorly understood mechanisms, the pain persists beyond the expected healing time. While this pain may remain in a localized area like a low back or ankle, sometimes it can also become more widespread over time. This can happen through a nervous system response called central sensitization, where pain alters your sensory processing systems to cause the nervous system to get stuck in a pain feedback loop, leading to changes in the nervous, immune, and endocrine systems. Other times, widespread chronic pain is caused by another illness process, such as an autoimmune condition. Unfortunately, chronic pain causality is often messy to diagnose, and can take years of doctor's visits (if ever), with a progressive decrease in quality of life during that time. We will help you try to reach an informative diagnosis, but regardless of the cause, our goal is to help you find ways to increase your quality of life and physical function, understanding that the fact you are living with pain has real, tangible impacts on your daily life. We have spent years studying pain science, driven both personally and professionally, to understand better how to help the body learn to cope with a long-term pain process. Wherever you are in the chronic pain experience, we can help you better understand the physiological pain process, giving you tools to both work within and challenge your body's current limits.
How do I manage chronic pain with physical therapy?
This tool box will look different for each patient. Chronic pain is a complex sensory and emotional experience that requires a comprehensive & multidisciplinary approach to management. In other words, it is an experience that touches every aspect of your daily life and often requires multiple providers to help manage effectively. In physical therapy, our goals are to help you improve both your understanding of your pain and to increase your physical functionality, so that you can:
Live with a lower baseline level of pain
Understand what pain is related to true tissue damage and what is not
Improve self-monitoring of your pain levels - to reduce the frequency and intensity of pain spikes and flare-ups
Know what to do when you have increased pain
Do more with the same level of pain
Ehlers-Danlos Syndrome / Hypermobility
Hypermobility Disorders
If you know you have an Ehlers-Danlos syndrome, then it is likely that you have already been through some of the process described in the section above - countless doctors visits with misdiagnoses, inconclusive tests, and physical therapists who either push you past your limits, or are afraid to break you.
If you don't have a diagnosis, but have widespread pain, have always been more flexible / mobile than your peers, abnormal scarring, or have had multiple dislocations (even from low-force trauma), you may have hypermobile Ehlers-Danlos syndrome (hEDS) or another hypermobility spectrum disorder (HSD) which is responsible for, or related to your pain.
Either way, if you're looking for a provider familiar with hEDS and HSD, you're in the right place.
What is Ehlers-Danlos Syndrome (EDS)?
Ehlers-Danlos syndromes are a group of inherited connective tissue disorders which are associated with joint hypermobility, tissue fragility, skin hyperextensibility, and typically come with some form of chronic pain.
There are 13 different types which can affect not just joints and skin, but your blood vessels, eyes, heart, and most body systems. Management is typically multidisciplinary due to high variability in its presentation, and different providers will be best suited to help based on your specific type and presentation. However, the most common type is hypermobile EDS (hEDS), which is what we have the most experience treating. Outside of hypermobility and pain, signs of dysautonomia such as Postural Orthostatic Tachycardia Syndrome (POTS) are common in this crowd, which can present as an elevated heart rate, dizziness, fainting, shortness of breath, or palpitations with postural changes or standing. Unfortunately, no genetic testing yet exists for hEDS, though it is available for certain other types of EDS; instead, a diagnosis is reached through a series of diagnostic criteria, which a knowledgeable provider can take you through. For more information, check out the Ehlers-Danlos Society website.
Our Experience
In Colorado, Ian worked in a clinic that served as a major referral point for physicians who treated EDS in the area, and alongside a therapist with hEDS. Over the course of 4 years there, we helped dozens of folks manage their EDS, reach a proper diagnosis in some cases, and find resources and other providers familiar with the syndrome to assist with management.
Outside of treating hEDS, Ian spent 3 years working in youth gymnastics, where hypermobility is a abundant trait - through a combination of this practical experience and continuing education in both generalized hypermobility and EDS, we have become proficient in the treatment of hypermobility related disorders and injuries.
If you have, or suspect you have, a hypermobility spectrum disorder, hEDS, or a hypermobility related injury, we're here to help you manage it.
Schedule your evaluation OR reach out for a 15 minute free phone consult to see if GOAT House Physiotherapy is right for you
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