The majority of people who encounter a chiropractor do so because they have something that hurts. It could be chronic shoulder pain or it could be lower back pain that flares up every couple of months. The first instinct is always to get rid of that pain, immediately. But what’s interesting is that there’s a vast difference between making pain go away and assessing its root cause to discover why it came about in the first place. Pain management and functional movement care are worlds apart.
Pain management aims to reduce symptoms. Pain management aims to get people feeling good enough to resume their lives. Functional movement care seeks to understand the mechanical function of the body and relearn proper patterns. The two are not mutually exclusive, yet it’s the mistake of interchanging them that leaves far too many people stuck on a merry-go-round of the same problems.
What Pain Management Actually Does
Pain management is not bad and there are legitimate times when it is appropriate. When someone is experiencing acute pain that’s negatively impacting their quality of life, relief is essential. Pain management involves injections, medication, anti-inflammatories, focused manual therapy on the painful area or modalities to calm inflammation or lax tight tissues.
Pain management becomes negative when it does not serve as one part of a larger recovery plan. Over-the-counter anti-inflammatories can effectively reduce swelling in an aggravated knee, however, if it’s weak from hip instability or decreased ankle mobility and doesn’t have the support it needs, the medication will keep it quiet long enough to re-injure it again once the person gets back into a routine. Pain returns with a vengeance, but the underlying dysfunction never got addressed.
This can be likened to taking your car into a shop with a weird noise. If the mechanic just turns up the radio, they haven’t addressed anything. They’ve merely ignored the warning. It’s the same with pain, it signals that something is wrong.
Understanding Movement
Functional movement care takes a different perspective altogether. Rather than focusing on where it hurts at that moment, functional movement practitioners assess how well someone moves as a system. They can identify compensations, weaknesses, tissue restrictions and any issues impacting how someone moves through daily tasks.
For those who have had persistent problems without relief from alternative measures, working with a Chiropractor who specializes in functional rehabilitation provides the best long-term results. This form of care focuses on movement dysfunction instead of just trying to find the source of pain and chasing it around the body.
The standard assessment involves how well someone can perform basic patterns (squat, overhead reach, rotation, single leg balance). Those with limited hip hinge ability usually have greater instability elsewhere. Those who can barely put their arms over their head without cringing might just need some scapular stability training, but they could also have tight pecs or restrictions within their thoracic spine.
A shoulder injury may indeed be a shoulder injury, but it’s just as often related to limited thoracic mobility. Knee pain could be attributed to chronic wear and tear or patellofemoral syndrome, but more often than not it’s coming from weak glutes forcing other structures to compensate.
Your body is one intricate system made up of smaller parts, all working together for proper movement patterns. When one area doesn’t function as intended, surrounding tissues step in to pick up the pieces. This compensation works fine and dandy in the short run; eventually, however, those making up for the lost region now get overworked and that’s when pain sets in.
Take for example someone who sits at a desk all day, hunched over with their head forward and shoulders rounded. The upper trapezius and neck musculature are working overtime to hold that positioning and sooner or later, they’ll develop tension headaches and neck pain. If this person goes in for a massage or prescription muscle relaxers for treatment, they get pain management but if they don’t change how they move and position themselves, their headaches will always return.
Where Functional Movement Care Comes In
If these same people assess their restricted thoracic mobility with rounded scapula and subsequent weakness, which leads to a head position forward, they can strengthen what needs to be better aimed and retrain their positioning patterns for sustainable success.
It takes longer and works gradually, but it actually works in the long run.
Why the distinction? Pain management is passive, it’s something done to you. You take a pill or get an injection; someone (hopefully) massages you; you don’t have to change how you move or do anything different.
Functional movement care is inherently active. There might be a component of manual therapy that’s included with treatment efforts but it’s always paired with effort that’s required on your end. Functional movement care includes exercises, retraining of certain movements and corrective strategies that rely on you actually doing something to get better.
This also gets expensive for people who want pain management as treatment because the longer they’re dependent on multiple appointments until an area feels good enough to avoid pain again doesn’t build their ability to manage their condition independently. Temporary relief gets felt but it’s not cheap over time nor sustainable.
When Pain Management Is Appropriate
Are there situations where pain management is ideal? Absolutely! Acute injuries require initial symptom control; post-surgical accidents require pain medication; chronic conditions that are never going to fully resolve still necessitate pain management strategies to keep discomfort under control.
But even then, functional movement work plays into the mix. Someone with an ACL tear needs intervention for pain management but they also need treatment for knee function restoration (at least in terms of strength development and confidence). Pain control helps them feel good enough during the acute phase after surgery; functional movement helps them transition back into action thereafter.
For most chronic pain situations, the back that’s always been bad; the shoulder that acts up after overhead work; the hip that gets tight after walking for too long – functional movement should serve as primary source for intervention with pain management an initial secondary play at best.
What Functional Movement Care Really Does
On your first visit for functional movement intervention, an extended history assessment takes place. Practitioners want to know what you did at home prior to coming in; they want a report of what’s bothering you, what helps, what makes things worse; they want to see how your body is moving (or not) through various patterns, what’s the history behind this complaint and what’s happening beyond just looking for relief?
Effective treatment will include manual therapy for joint mobility and/or soft tissue reduction, but only as preemptive mobilization before getting down to business dealing with an actual return to movement effort. They want to assess what’s tight or restricted before creating a plan that involves targeted weakness-focus efforts and helpful strategies you can implement outside the therapy room.
Whereas progress gets measured through assessing pain scales before transitional movements after, for example, functional care goals focuses on squat depth overhead reach capabilities, or even walking distance without discomfort. Those efforts gauge actual improvement in capacity instead of based on feeling better.
The Long-Term Picture
This works for people better in the long run because those who put off functional movement care eventually learn their own body better, they know what movements/positions look good or bad; they have tools at their disposal after sustaining minor flare-ups because they’ve tracked what worked before and therefore aren’t doomed in a cycle of appointments without anything that’s lasting change.
That said, pain management approaches are not worthless per se, they’re incomplete with what’s possible when movement patterns sought to diagnose what’s wrong instead.
The best case scenario is when pain management tools get successfully applied as needed to make someone comfortable enough to engage in functional work before gradually transitioning back toward movement-focused care as a sole means of intervention.
Your body is meant to move. When movement processes break down, this is when injury occurs. Simply taking away what’s painful is not enough; restoring efforts toward avoiding further patterns of discomfort is what’s needed in addition to finding out why those patterns made an appearance in the first place.