It is International Pain Week and we have something important to discuss. Working as a physiotherapist I encounter pain is almost every client that I see within the clinic. With the continual rise of pharmaceutical companies, an interesting bit of trivia has emerged from the Bayer organisation, stating if you line up the amount of aspirin consumed yearly, the line would stretch to the moon and back! Despite the advances in science and medicine in regards to pain, the number of people “suffering” persistent pain has increased. Along with this increase, the cost of pain to society has increased as well, with an estimated cost of pain at $33 billion in Australia alone.

Tissue damage, pain and pathology don’t always correlate

Too often I am confronted by my patients reporting that the findings of their radiographic images (x-ray, MRI etc) is the source of their pain. For some patients, these radiographic images can provide significant evidence that can help guide treatment, however, for others these images can provide false clarification of their pain without appropriate correlation. I emphasise with my patients the importance of correlating findings of the clinical examination, subjective history and radiographic images. This is especially important with lower back pain, as the current literature confirms spinal degenerative changes shown on radiographic imaging are not pathological but rather due to the normal process of ageing that is not related to the patient’s clinical presentation.

Pain is a critical protective device

Pain despite being an unpleasant sensory and emotional experience teaches our brain and body to protect itself from known painful stimuli. Remember the time you were told not to touch the hot stove? What did you do? You touched it and WHAM you burnt your hand. This protective device can promote negative outcomes such as fear-avoidance, anxiety and maladaptive movement strategies, especially surrounding a painful experience for a non-painful stimulus. I have learnt that no two people will experience the same pain, despite having similar clinical presentations, with this being due to the clients past experience, knowledge, beliefs and culture.

Perception influences your pain experiences

Negative communication from clinician’s and the media can influence your pain experience. A recent study explored this by directing negative communication to a patient when describing their injury. They found these individuals’ felt as if they were a burden to society due to their pain, thus causing insecurity, mistrust and an inability to take control over their pain. Communication and discussion regarding pain is a sensitive topic due to the anxiety and fear surrounding the topic. It is important to remember that everyone experiences pain differently and perceives their pain very differently to you, and thus we should listen first before placing your perception onto others.

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Larry is a highly skilled physiotherapist who specialises in treating back and neck pain, postural issues and scoliosis. He is certified in Schroth and SEAS methods and through the Egoscue University. Larry has a background in elite gymnastics and springboard diving and also has many years experience in endurance running and triathlons. His specialist knowledge and techniques have seen him appointed as a gymnastics coach and physiotherapist at both the Olympics Games and Special Olympics.

His passion and driving philosophy is about achieving the best outcomes for his patients utilising an amalgam of the latest techniques and theories while recognising there may sometimes be a need for invasive procedures. Where deemed appropriate Larry will then refer to a specialist. To further his holistic understanding and approach, Larry is currently undertaking a Ph.D. in Spinal Deformity and regularly attends and speaks at international conferences and courses and clinics.

Fun fact: Larry is learning how to surf - so be careful next time you go to the beach! Qualifications: B.Sc (Physiotherapy); M.Sc. (Exercise Physiology); Advanced Certificates in Schroth (BSPTS) and Egoscue (PAS) and SEAS Larry is Level II certified (advanced) in the conservative treatment of Scoliosis based on the Schroth method. The training was conducted by Dr Manuel Rigo of the Barcelona School at Scoliosis Rehab Inc in Wisconsin. He has completed his SEAS scoliosis treatment training at ISICO in Milan. Larry has also spent time working with Dr Rigo in the Barcelona clinic. Larry also has advanced certificates in shoulder treatment, posture alignment therapy and acupuncture.