Symptom Variability Part I

Symptom Variability Part I
 
I have said for years that pain modulation/regulation/management in therapy is not difficult and it’s not rocket science.  My goal as a therapist is not to make symptom management harder than it has to be.  In its simplest form, pain management is about identifying patterns – what brings on your symptoms and what takes away your symptoms.  Examining what brings on and takes away your pain is an effective way to manage variable pain.  This practice is convenient for physical therapists because the large majority of orthopedic pain is variable. 
 
Let’s first define variable pain.  Variable pain indicates that the pain or the individual’s chief symptom complaint changes.  In other words, the symptoms are not constant, they VARY.  This may be in relationship to pain intensity, location, or type (ache, sharp, burning, tingling).  If the symptoms change at all, in any way, then your symptoms are considered variable.  For our example, today we will discuss pain variations as that is the easiest for most people to relate to.  
 
The chart below illustrates pain levels that change through time.  As we can see with the chart, pain will rise and fall throughout the day – sometimes higher and sometimes lower.
 
Invertabelt Andy Champion education oakford group
 
 
 
It is common for people to try and block out pain, as most do not want to become fixated on their pain.  This can sometimes be a detriment as people become unaware of what may reduce or provoke their pain.   The key to managing symptoms is identifying periods of time when your pain is better or worse.  Recognizing when we are in more pain isn’t difficult. It can be more challenging recognizing when are symptoms are our better or our best (sometimes this is routinely overlooked).  The chart below illustrates periods of time when symptoms are at their highest and lowest.   
 
 
Invertabelt Andy Champion education oakford group
It is important to look at the activities that we are performing when we are both feeling better and feeling worse, as these activities may be exasperating the pain.  Start pairing your activities/actions while you are feeling better or worse -see if you notice any patterns. 
In part two we will look closer at the activities that may lead to increase pain provocation and strategies in identifying these activities.