When we assess a patient, we’re trying to determine how long the injury has been going on, when did it occur. And so, one of the first questions I will ask patients throughout my history is, “How long have you been dealing with this injury? What contributed to it? What are some things that make it better or worse?” Those types of things. I’m trying to determine if it’s an acute situation or more of a chronic condition.
An acute condition is one that typically occur secondary to trauma, maybe some form of an accident, something that happens relatively quick. If I were bending over to pick something up off the ground and I felt a low back strain, that’s more of an acute type situation. In acute situations, patients may present their problems or relate their symptoms more as sharp, shooting, those types of complaints, stinging. So we’re talking about within 24 to 48 hours. Relatively, a day or two would indicate more of an acute type injury.
Acute type injuries, believe it or not, most of them are easier to fix, relatively speaking, as opposed to a chronic type injury. Patients always ask me, “If there’s one thing that you could see, what do you love to see, Dr. Riley?” And acute neck pain is what I really like. I slept awkward. I woke up, I had localized pain on the right side of the neck. I might’ve had a little bit of shooting pain down into my shoulder blade or my arm. As I go through their history, I make a determination that I’m not worried about any nasty underlying causes. It’s likely an acute strain type injury, so within a visit or two, I can likely resolve the condition. Those types of acute episodes, I really appreciate treating because I know the outcome is going to be generally speaking, good, and it’s going to go relatively quick.
A chronic type injury is something that has been going on for a longer time. Those can be more challenging because many times they’re associated with some underlying factors. They might have chronic degenerative disc disease or arthritis. They may have chronic muscle strain or spasm. They might be overweight. There’s something that we refer to are comorbidities, or things that are associated, or complicating that condition. So many times with chronic conditions or situations, there’s other factors that we’re dealing with. And when we’re dealing with those other factors, it can make the outcome a little more challenging. It sometimes could take us a little bit longer to fix. Sometimes as patients, those types of conditions can be more frustrating because we’ve been dealing with them for such a long time. They can affect us emotionally, mentally, they can wear us down. So chronic conditions are something that have been going on for some time now.
Something else I’d like to talk about is something called cumulative trauma. Many times patients come into the clinic and I ask them, “What caused your problem?” And they look at me, “I have no idea. I did nothing. I literally went to bed and woke up. Or I transitioned out of a chair.” And as a patient, that can be very frustrating because I think inherently it makes more sense if we did something and then there was a result. And I can say, “That is what happened and that’s why my back hurts.” But many times there’s not an aha moment or a specific episode that causes that.
So I talked to the patient about cumulative trauma. And cumulative trauma is just day in, day out stuff that we do. For instance, me sitting at this desk, day in, day out, looking down on a computer screen, postural abnormalities, cumulative trauma. I don’t stretch enough. I don’t go to the gym enough. So it’s an all-encompassing thing. I talk about cumulative trauma daily with my patients, and it’s like what we have done associated with what we haven’t done. So the next time that you have it, maybe have an injury and there’s not a specific event, take some time to consider some things that you’ve been doing repetitively over the last few weeks, months, years, associated with some things that you haven’t been doing. I’ve not been going to the gym, I’ve not been stretching, I’ve not been paying attention to my posture. Those are some things to consider.
So three types of conditions. We have acute conditions. Those are the ones that happen relatively quick within a day or two, typically associated with some type of traumatic event, or we can point our finger at one thing. A chronic condition going on a little bit longer, many times associated with different underlying factors. And then we also talked about cumulative trauma, those things that we do day in, day out. Whatever the case may be, whatever type of condition you may have, whether it’s acute, chronic, or it’s something associated with cumulative trauma, I really encourage you to get it checked out, get the appropriate diagnosis, and really important, establish the appropriate treatment plan with whoever it is.
At Tulsa Spine and Rehab, we offer integrated care, comprehensive modalities, multiple options for you as the patient. So remember, Tulsa Spine and Rehab, we always say, “Keep moving.”