The Body Keeps Score

As a postural restorative physical therapist of 11 years, I have interacted with hundreds of patients with varying ailments and complaints. The common denominator in all these patients’ experiences is a four-letter word.
Pain.

Pain is our body’s response to injury, and believe me, it is as real as the heat of a Texas summer day. However, the reason pain levels and symptoms vary from individual to individual can be much more complicated and are almost impossible to fully understand.

The human body is composed of many complex systems. The musculoskeletal system is the framework of the body, providing support and movement. The circulatory system brings oxygenated blood to our cells and takes the depleted blood away. The respiratory system works with the circulatory system, providing oxygen and disposing of carbon dioxide. The gastrointestinal system breaks down food into usable nutrients, while the endocrine and nervous systems control the whole circus. They all directly influence each other to varying degrees and integrate accordingly to keep us alive. Due to the intricacy of our bodies, a thorough history of one’s life is necessary to determine current conditions and potential future forecast. After all, the body keeps the score.

When an injury occurs or pain arises in the body, it can be very easy to become a keyboard warrior on WebMD. However, if Googling or WebMD provided all the information needed to recover from injuries and decrease nagging pains, I would probably be out of a job. Every patient’s circumstances are different, just as every person is different, and I always strive to look at the big picture and not simply the symptoms and complaints in front of me. Various factors affect a person’s recovery, and no two people are the same.

Factors that can affect healing include:

• Stress levels: Are you stressed in your professional and/or personal life?
• Sleep: Are you sleeping enough? Are you sleeping too much? Is your sleep constant or interrupted?
• Nutrition: Does your diet consist of healthy or unhealthy food? Do you cook regularly or get take-out? Do you skip meals?
• Dental: Believe it or not, your dental health is a good source of information about the rest of your body! Have you had any dental work done? Do your gums bleed easily?
• Physical: Are you active or sedentary?
• Recent Illness: Have you recently recovered from an illness? What was it? Are you suffering from any lingering effects?
• Trauma History: Have you had any surgeries? Have you broken any bones? Have you been in a motor vehicle accident?
• Medications: What medications, including over-the-counter medications and herbal supplements, do you take? Have you recently started or stopped any medications?

It may be hard to believe that these factors can affect healing, so I have a couple of examples to convince you.

One of my patients grappled with chronic neck pain and tension for five years. After multiple sessions with other practitioners of various medical disciplines, the patient had lost hope of finding an answer for his neck pain. By asking detailed questions, I learned he had dislocated his jaw while wrestling in high school and had orthodontic treatment that ended about six months before the onset of his neck pain. I was able to assess the occlusion of his teeth and realized that his bite was affecting the way he was holding his head and neck, causing dysfunction. He was referred to a dentist for a mouth appliance and continued with a few exercises, and his pain was quickly relieved.

Another interesting case was a female in her early 30s who suffered from almost constant right ankle sprains and pain for over 12 years. Her medical history revealed that her vision was corrected with monovision. This disengaged her eyes’ ability to work well together. She didn’t have an ankle problem; she had a vision problem. Her ankle instability was a direct result of her visual field.

Our body is constantly managing stress, as well as sensing the environment in which it lives. It remembers injuries from years ago. What may had seemed an insignificant fall or bump might be an exacerbating factor in later injuries. To gain true healing, we must consider the whole body’s history to best resolve the current complaints. As a consumer of healthcare and a provider of healthcare, I find the more we know, the better we can work together. And always remember, the body keeps the score.

Kasey Aikin, PT, DPT, PRC is the owner of PRISM Physical Therapy in Fort Worth.