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  • Q&A with Australian Health Practitioners

    How can I get my chronic pain assessed?

    I have bulging discs, fibromyalgia and hypermobility joint syndrome, si joint degeneration, my mobility is getting worse, as well as the pain, as has gotten worse of the last 15 years, how can I get my joints re scanned to see how much has degraded of the last 15 years, I follow all the usual exercise diet and physio regime but would like to to be rescanned as my condition has significantly worsened in the last 6 months.
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    Andrew is a bayside local who has been working in the area since gaining his Masters in Osteopathy from Victoria University, Melbourne. He has always ... View Profile

    Chronic pain is a complicated warning signal from the brain created in response to a threat or potential threat of damage to the body. Interestingly it actually has a poor link with what the anatomy actually looks like or if there is damage to the tissues. That's why some amputees can experience phantom limb pain and some people can experience terrible wounds in battle and not realise. Often there is a big context element to what we feel and experience. 

    If you were to get a scan there is no doubt things will of degraded in that time. That is perfectly natural and often people who are completely asymptomatic will have signs of disc degeneration and joint wear and tear. 

    It sounds like your management routine would be better off being updated for your current condition as things have significantly worsened and it would be worth while seeing another manual therapy practitioner who has experience with chronic pain.

  • Michelle O'Sullivan

    Occupational Therapist (OT)

    I have extensive experience in the management of hypermobility, chronic and rheumatological conditions such as rheumatoid and osteoarthritis. I now work exclusively with patients with ... View Profile

    If you haven’t had scans in the last 15 years it would be worthwhile getting updated scans. A lot can change in a body that is hypermobile and with a history of bulging discs. 

    I would recommend seeing a Rheumatologist for scan referrals and an update of your pain management, including exercise and physical therapy routines. A consultation with an occupational therapist could help you manage your day to day activities in ways which are less painful and help to protect your joints. 

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    Helen Potter

    Physiotherapist

    As a Specialist Musculoskeletal Physiotherapist, with extensive experience and highly advanced qualifications, as well as excellent communication skills, I can help you to: Become informed ... View Profile

    I disagree with one of the previous recommendations. More scans will only confirm more anatomical ageing and won't help you pinpoint or treat your chronic pain which is widespread. A huge proportion of findings on scans are irrelevant to your pain and only raise your fear and sense of helplessness.

    You would be better in my opinion to see a Pain Specialist or Specialist Physiotherapist to overview your problems and to take a management approach. Specialist physiotherapists, discuss what your specific functional problems are, ask what activities you are having trouble with, and what your goals are for the consultation. We look at your medication, movement patterns and overall physical activity. Scans would cost you about $800 for each area you have pain and won't tell you how you can help yourself. Spend the money instead of more effective intervention looking at why you have chronic pain and what you can do to manage it better. Helen 

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    Michelle O'Sullivan

    Occupational Therapist (OT)

    I have extensive experience in the management of hypermobility, chronic and rheumatological conditions such as rheumatoid and osteoarthritis. I now work exclusively with patients with ... View Profile

    With significant joint hypermobility the patients joints will most likely have changed significantly in 15 years, and not in a normal pattern of anatomical ageing. Quite to the contrary. There may be cartilage tears, ligament and capsule damage from subluxations or dislocations that need addressing. Without imaging, how do you know what you’re dealing with? 

    As I stated above, my professional opinion is that a Rheumatologist should be involved. Let the specialist decide which joints need scanning. An MRI with referral from a specialist on a Medicare-eligible machine is in my experience closer to $300 out of pocket and for pensioners, either no out of pocket or up to $100. 

    It appears that my logic is opposite yours. I think, why waste hundreds or thousands of dollars on treating things blindly when science and modern technology allows us to see with more accuracy than ever what’s going on? Then, by all means, treat what is needed. I’m a huge fan of physio and work extremely closely with them, I just do not believe in blindly treating a hypermobile body without checking what’s really going on. 

    Occupational therapists and physios often see things from opposite perspectives, and when joint hypermobility is involved even more so! 

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