| An often overlooked yet crucial factor in the
treatment of chronic pain is rehabilitation. Whilst treatment
of the initial pain episode is of huge importance, rehabilitation
is essential if recurrences of pain are to be avoided.
Rehabilitation is the combination of
specific treatment and a tailored exercise programme to accommodate
the patient’s needs. Such exercise programmes are rarely given
in the initial stages of treatment, because exercise can often
aggravate rather than help in the first four to six weeks.
Should I have bed rest?
The prevalence of back pain in today’s
society has largely come about by lack of knowledge about function
of the spine and the other joints of the body. Until recently,
people complaining of back ache were told to have complete bed
rest until the symptoms had subsided. However, current thought
is that if you have more than two days of bed rest, you are more
likely to have recurrence of the pain in the first year.
With the first episode of back pain, acute symptoms
generally subside within a week to ten days and pain usually completely
resolves within about six weeks. However if the causal problem
is not addressed after the first episode, the chances of another
bad episode within four years are significantly increased.
Rehabilitation then, is essential for those who
do not wish to suffer from chronic episodes of recurring back
pain.
Chiropractic rehabilitation
Traditionally, chiropractors have always
used exercise in their approach to any kind of joint problem.
The cause of each episode of pain is pinpointed and treated, after
which an exercise programme is drawn up and supervised to prevent
recurrences of the problem.
 
Not everybody needs the same type of exercise programme
and your chiropractor will tailor your basic programme to your
specific needs. They may choose to teach you personalised stretching
exercises to increase your flexibility or muscle strength exercise
to tone and condition muscles.
More important than the details of the exercise
programme is the willingness of the patient to actually do the
exercises on a regular basis. It is important that exercise regimes
are introduced gradually and monitored carefully. A proper rehabilitative
programme will target flexibility, endurance, strength and the
co-ordination of the muscles.
 
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- Flexibility
stretching
- Aerobic
exercise for endurance
- Resistance
exercises
- Strength,
balance and co-ordination exercises.
 
Stretching muscles should be done slowly and gently. In
the first few seconds, the brain tells the muscle to shorten to
protect it from being over-stretched. After approximately six
to ten seconds the brain perceives that the stretch is safe.
It is the next 20 to 24 seconds that the stretch has the most
beneficial effects. This is why a stretch should be held for at
least 30 seconds. When you are stretching, if you feel an uncomfortable
sensation for more than 10 seconds, you are stretching too far
and too fast. You should ease off slightly until the sensation
has gone and then hold for 20 seconds.
It is important that when you are stretch you do not bounce. This
may actually cause nerve damage and muscle fibre tearing and does
not improve your flexibility.
Aerobic exercise releases stress-reducing hormones,
burns fat and so reduces body weight. It also increases your energy
and sense of wellbeing.
It therefore works in two ways: not only strengthening
muscles so that pain episodes are less likely to occur, but also
reducing the tension that can cause muscle injury in the first
place.
 
The majority of a chiropractic exercise programme
can be done at home, but if you have access to a gym you may well
get more out of your exercise programme. Around 20 minutes, three
times a week but ideally should become a life time habit.
Exercise programmes have been proven to prevent
back pain and other joint pain, but exercise can only have a lasting
effect if it is continued for a minimum of three months.
You should never undertake an exercise programme
when you are in a lot of pain or without the advice of your chiropractor.
They will be able to advise you on the type of programme best
suited to your needs and the activities of daily life.
Many
studies have shown that by maintaining a rehabilitation regime,
patients ensure that they suffer less recurring back pain, maintain
increased flexibity and suppleness and enjoy their lives without
the fear of chronic pain.
By working with the chiropractor to refine the perfect programme,
the patient can use chiropractic rehabilitation to dramatically
improve their quality of life and reduce their risk of suffering
pain episodes in the future.
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