Northern Michigan Sports Medicine Center - pain Tag Tue, 15 Oct 2019 23:58:59 +0000 Common Angle – en-gb Maximize your mobility Why do I hurt more when it's cold?

I’ve written at length in the past about different aspects of acute and chronic pain as it relates to musculoskeletal injuries.

One specific area under the pain umbrella I’ve not discussed in detail is how your nervous system changes and becomes more sensitive when you hurt.

If you’ve been in pain for a long time, other body systems may become more sensitive to stimuli.

Here are some ways in which your nervous system responds to different internal and external stimuli when your pain levels are elevated:


Believe or not, there are temperature sensors in your nerves.

When you get cold, it is normal to feel more aches and pains in the affected area.

There are several patients I see for a tune-up every November before the weather turns colder in hopes that they have fewer aches when it starts to turn frosty.


Other sensors in the nerves are sensitive to the chemicals released into the body when we’re under stress.

Higher levels of stress chemicals in the body increase the likelihood that higher pain levels are on their way.

It is for this reason that a comprehensive pain management program almost always includes some kind of stress-relief training.

Motion and pressure

If you’ve ever had surgery, you may have noticed that moving the affected body area can be painful for awhile afterwards.

This is because of pressure sensors in the nerves and is a normal part of the recovery process.

With continued movement over time, the intensity of the pain decreases and you start to feel better as you return to normal activity.


When your body is fighting illness, the nerve senses the immune chemicals circulating through your system and becomes more sensitive.

When I’m working with a patient who has had a mild to moderate increase in pain for no apparent reason, I usually wonder if they’re fighting off a cold or the flu.

More often than not, they cancel the subsequent appointment because of illness.

Blood flow

Have you ever wondered why you feel so dang stiff after sitting for an extended period of time?

Part of the reason is that your nerves can sense when blood flow is diminished. As a result, they become more sensitive for a few minutes after your start moving again.

Research has shown when a person is educated in why they are having discomfort and how it can affect them, their pain actually diminishes.

A small study conducted in Australia by Lorimer Mosley provided some fascinating evidence of this phenomenon.

A diagnostic tool called fMRI was used to measure activity in specific parts of the brain during a physical or cognitive task.

When the study subject was initially asked to perform a task, the areas in their brain responsible for pain immediately became very active.

After completing 2.5 hours of pain education, the task was repeated. This time, the areas which perceive pain were silent, and the subject did not report any pain.

The take-home message here is that knowledge is power. If you or someone you care about has been experiencing pain that is hard to cope with, ask your doctor for a referral to a physical therapist who has had extensive training in pain education and treatment.

Let us be your guide toward a life with less pain.

Jeff Samyn is a physical therapist, board certified orthopedic clinical specialist, and certified strength and conditioning specialist. He can be reached via e-mail at This information is not to be considered medical advice and is not intended to replace consultation with a qualified medical professional.

Read more]]> (Jeff Samyn, PT, OCS, CSCS) News Thu, 07 Mar 2019 13:55:40 +0000
In pain? Give physical therapy a try first

It probably isn’t news to anyone we’re in the midst of an opioid crisis at the national, state and local level.

According to the Centers for Disease Control and Prevention (CDC), in 2016 more than 42,000 people in the United States died from an opioid overdose, including more than 17,000 whose deaths were attributed to prescription opioid overdoses.

That’s almost 50 lives lost every day. Deaths caused by overdose of prescription opioids have quadrupled over the past 15 years.

While the mechanisms behind this increase in opioid related deaths are multifactorial, there is a concerted and growing effort being made to reduce the amount of opioids consumed by people in pain.

Opioids remain an effective tool for addressing certain types of pain when prescribed and taken correctly. That being said, in the past few months, our physical therapy practice has been affected by efforts aimed at reducing opioid use.

More than ever, physical therapists are serving as educators and coaches

I have worked with many patients between the ages of 25—85 over the past 12 months who are working with their healthcare provider to reduce the amount of opioid medications they are taking.

One of the possible effects of prolonged use of these medications is called opioid-induced hyperalgesia. This means that some patients who are given opioid medications actually become more sensitive to pain.

Some even start to experience pain with activities that never caused it before. According to the Journal of Neuroscience, this phenomenon has been observed in animal models after just a single large dose of opioids.

As the dose of opioids is reduced, patients are often unsure what types of pain they should work through and which types they should avoid. Physical therapists who have had comprehensive training in pain education and management help guide patients through this process.

We’re seeing patients earlier in the injury/recovery process

According the American Physical Therapy Association’s white paper on pain management: “The treatment of pain, particularly chronic pain, often requires an integrated, multidisciplinary approach due to the many variables that may contribute to a patient’s perception of pain and response to treatment.”

Given the subjective nature of pain, it is among the most complex problems for a healthcare provider to address. Contributing factors to how one person handles pain compared to another include stress levels, work and relationship satisfaction, fitness level, diet, and past experience with pain, to name a few.

All of these must be taken into consideration when a treatment plan for pain is formulated.

The combination of increased awareness of opioid-related issues and changes to prescribing laws has moved physical therapy up the list of suggested treatment options for pain of all types and moved opioids down the list.

As a result, we are seeing patients for the first time a few days or weeks after the start of their pain, as opposed to months later.

In summary, as physical therapists, our role is to be educators and coaches. We reinforce pain education concepts that are introduced by the patient’s physician, troubleshoot barriers to improvement that pop-up at home or at work, reduce the fear associated with injury, and teach patients how to move safely as they heal.

Though we are in the early phases of addressing this epidemic, the medical community is figuring out safer and more effective ways to help patients in pain.


Read more]]> (Jeff Samyn, PT, OCS, CSCS) News Thu, 23 Aug 2018 15:11:44 +0000
Cervicogenic Headaches

Cervicogenic Headaches

Headaches are an occasional occurrence for many of us and a part of daily life for some of us. There are several different varieties of headaches; migraine, tension, cluster, and sinus. The images below show where different types of headaches tend to manifest.

headaches 1headaches 2

Image Courtesy of Image Courtesy of

Cervicogenic headaches (CHA) tend to manifest in the neck, back of the scull, and around the temple area. These types of headaches tend to be very painful and debilitating, and many people deal with them for years. One of the main culprits for this type of headache is irritation of the nerve bundles along the base of the scull. There are several things that can contribute to the development of CHA’s. These can include TMJ problems, poor posture, poor ergonomics at work, and muscle imbalances in the neck and shoulder blades.

Most people are surprised when their doctors send them to physical therapy to treat their headaches. After an evaluation is performed, we use a variety of techniques to address the causes of the pain. These techniques include modalities for pain, muscle re-education exercises, postural strengthening/stretching exercises, and manual therapy and massage techniques to improve joint mobility and muscle flexibility. If you have a desk job, we often visit your workplace to see if we can find some ways to improve the position you are working in.

If you or someone you know has suffering from chronic headaches, call one of our facilities for a free consultation or see your doctor to see if physical therapy is right for you.

Read more]]> (Jeff Samyn, PT, OCS, CSCS) News Wed, 30 Oct 2013 13:55:14 +0000