Physical Therapist: Stress and Chronic Pain in Our Every Day Activities

Hello, my name is Dexter Penaranda. I am a Physical Therapist who has been practicing the profession for 20 years but have been in and around health care and health care practitioners my whole life. I am 47 years old and both my parents have been Physical Therapists. My father is still practicing with me (for which I am eternally grateful), however my mother died a little more than 10 years ago (and I still miss her to this day). For whatever it is worth, our combined experience in the health care field would be over 100 years. I often like to think I am the sum our experiences as the stories they shared and the people we have met have accumulated in me, helping to mold me into what I am today.

Stress and pain. I have been fighting stress and pain for over 20 years in my professional life. That is because almost any diagnosis which I have worked with causes one or the other, or both (most likely both). By profession, I deal with people whose physical function has been limited in some way. Whether it be a neurological or a musculoskeletal problem, if the client needs me, a physical dysfunction will have arisen. By itself, physical dysfunctions will cause stress as there will be a change in lifestyle. This can manifest in a variety of ways: diminished walking/work/activity capacity; inability to handle/move objects; maintaining postural position in standing/sitting activities; even doing transitional activities such as going from sit to/from stand or getting in/out of bed; getting down or up from the floor/ground. All these activities and many more (we typically call the ADLs or activities of daily living) could be affected by a given diagnosis.

Debilities which arise from physical dysfunction also often lead to outright pain. Physical adjustments to doing ADLs differently cause stress on the musculoskeletal system. A simple ankle sprain or broken lower bone in either lower extremity disrupts economy of motion and stresses muscles/joints/ligaments and other soft tissues. Chronic stress of these areas lead can lead to acute/chronic swelling and pain of the associated soft tissues. This in turn can lead to further dysfunction as capacity in the overworked areas diminishes. A negative feedback loop (loops positive or negative are the way the body adjusts to changing conditions) and so debility leads to pain leads to further debility.

Physical therapy is designed to mitigate and reverse the negative trends created by the given diagnosis. For example, let us look at the ankle sprain. Add ice and elevation with compression and massage to reduce the effects of swelling/pain. The patient will be better able to tolerate weight bearing through the ankle joint, allowing for a more normalized walking pattern. Rinse and repeat, and depending on degree of sprain, sprinkle in strengthening and balance activities to sharpen ambulatory ability. The debility arising from the ankle sprain is addressed and even overall baseline function of the client can be elevated (depending on how high level or low level functioning the patient was based on the initial evaluation).

The essential key to treating that problem (and many others) lies in the ability to control swelling/pain and subsequent increase in stress that is caused by that problem. By mitigating these key factors, the negative trends/loops are reversed or otherwise avoided.

As mentioned in prior blogs, one of the tools that can be used to target pain/swelling and stress are CBD/THC products. CBD/THC interact with the Endocannabinoid System. CBD/THC molecules are designed to integrate with the Endocannabinoid System, whose pathways lead to a chemical cascade allowing for reduction of pain/swelling and stress.

You can try some of the various products which can enhance reduction of pain, swelling, and stress at:

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