How to know when I need some help

How to know when I need some help for my pain:

We trip, hurt our knee.  Twist a little too far, your back spasms.  That ache in your elbow that used to only be a problem when playing tennis is now bothering you at work and even just reading a book.  Checking my blind spot is nearly impossible now without turning my whole body.    

When is it ok to just let things heal in their own time and when do you need to get a professional opinion?

The best way to approach this questions is knowing what “acute” versus “chronic” means.  Acute injury symptoms are what the body presents in the first 24-48 hours on the initial onset of pain (ranging from pain that can be dull or sharp, redness, swelling, bruising, difficulty moving the affected area, pain-related weakness, avoidance of activity through protective movement mechanisms).  Chronic pain is when pain continues well after healing should be complete (3-6 weeks) with similar as well as very different symptoms (less swelling, more dull instead of sharp but perhaps increased pain even a rest, better movement range but perhaps still decreased, weakness in affected and perhaps increased locations, and protective movements can increase creating other areas that become sore). Chronic pain is much more complicated to resolve.

When we get injured, you should remember the rule of “FIDA”, for Frequency, Intensity, and Duration, Activity.  If you tripped, twisted your ankle, and immediately have pain, or maybe not much pain until the next day (when your body has had some time to begin the inflammatory response).  Pain could be very severe, even at rest, range of motion extremely decreased, and it could hurt just to have your foot on the floor.  The normal healing process should see incremental improvements of frequency (how often it hurts as well as how large of an area affected), intensity (how much it hurts), duration (does it recovery quicker with a movement that normally bothers it) and activity (are you starting to go back more normal activity levels and actions required of daily living).    My general rule is that if all of these FIDA areas are not incrementally improving within a week, I would get a professional to look at them to make sure that you are doing the right things, avoiding the wrong thing, and that things are not more serious that your originally thought.

With an injury, there are three stages to recovery.

1. Avoid further injury.. Action: avoid repeating the same thing again, cease current movement, make the “danger” stop.

2. Protect the area.  Action: Move only so as to not continue to hurt yourself, whatever compensations required, take medication if required, heat or ice, rest further.
3. Healed, move on. Action: realize enough time has passed to be out of danger, get back to normal movement and pain free life.

Sometimes there was no specific “injury” and your symptoms just seemed to crop up out of the blue or slowly over time.  Interestingly enough, even without the apparent “danger” signal to the brain, our bodies will still follow the same stages of recovery because of some action that we keep repeating (or lack of an important action) that leads to the brain reacting as if there were an injury.

A lot of non-serious injuries will start to heal and have noticeable improvement in pain levels, range of motion, and strength within 4-7 days with proper rest and avoidance of the “danger”, if known.  But if things are not improving by that time, there may be more to the issue than you realize.  And that is when you may really benefit from a professional to assess it to avoid the problem becoming chronic.  Obviously, avoiding an acute injury from turning to chronic is extremely important to anyone.   If you are wondering whether you should seek help, as yourself these questions:

1.  Have I seen continued improvement in pain levels, range of motion, swelling, return to activities?  (If you have not, seek help. If you had been improving but have plateaued after 1-2 weeks, seek help.)
2.  How long has it been since I could perform specifically affected activities? (If you are still unable to perform simple activities like sit to stand, looking behind you to talk to someone or checking a “blindspot”, taking the stairs, using your computer, walking without a limp, etc… without compensations or with increased safety risks within 4-7 days, seek help.)
3. Do you know what caused it or did the pain just “start out of the blue”?  Nothing is ever “out of the blue”, truly.  Perhaps you have been compensating for sometime to avoid pain, overusing one area to protect another, ignored any “danger signals” to get you to stop doing certain things that you just “work through to get it done”.  Get a physiotherapist to take a good scan of how you move and what you move.  They will find the underlying cause and help you got go from avoiding and protecting to resolving.