Hi friends! I haven’t posted in a very very long time. I had decompression surgery last December the 14th. After the surgery, my constant neck and head pain went away and I just had short bursting headaches remaining but they were much less frequent. I’ve been doing really really well and I’ve been able to exercise/do other things I couldn’t previously. However, the past two weeks I’ve been having more frequent dull neck pain that is basically constant and I’m wondering if anyone has any tips for dealing with this/ways to combat the anxiety it produces?
Unfortunately, surgery is not a guarantee for a pain-free life. I have done a number of physical therapy related techniques that have done a world of good - long-term with no medications. As with other health care practitioners, all physical therapists are not created equally. A more complex pool of knowledge is necessary to treat Chiarians and their complex and often chronic pain.
List of things that have actually helped for the long term and not just a band-aid.
Scar management techniques for scar and posterior head pain and sensitivity to touch (well-healed and done with post-surgery complications)
- scar massage and deep friction rubs, variety of different touch, self-myofascial work. This approach is not specific to Chiari but is applicable to all incisional scarring. Can your therapist teach you? Can you find the information on the web?
Neurodynamic exercises for funny arm, hand, and even foot pain.
-The Neuro-Orthopedic Institute (NOI) out of Australia offers courses for physical therapists. A good question to ask a physical therapist is if they have gone on a course or two AND do they practice the information in their clinic.
Motor control exercises for the neck, thoracic spine, and shoulder. A good question to ask a physical therapist is have they taken motor control classes and use it or have they taken any Shirley Sahrmann courses. She is a well-researched physical therapist from the States. Or Sean Gibbons courses - a physical therapist in Canada who offers courses in Canada, UK, and Europe.
Trigger release Methods - This is self-applied pressure to different muscles in the head, neck, and shoulder area that are amazing in removing pain and assisting in normalizing movements that you learn in motor control exercises. There is a book for the average person called “The Trigger Point Therapy Workbook” by Davies and Davies. If it is becoming difficult to find a skilled physical therapist, I would recommend starting with the book on your own.
Graded motor imagery exercises are good for funny hand, arm, head pain as central sensitization can set in with the Chiarian population. Check out NOI’s book, “The Graded Motor Imagery Handbook” for more information. Of course, ask a physical therapist if they are familiar with this, can identify centralization, and are equipped to treat it. Perhaps NOI has a list of physical therapists in your area that have taken courses. I have never asked.
Understanding pain, its complexities, and the role of the brain are very important in helping you to find the help that you need and be motivated to do the work necessary to get beyond chronic pain. I make no promises that pain will be banished completely for everyone and that pain medication is thrown away, but deeper understanding can provide a more meaningful life. NOI’s book, “Explain Pain” is written for folks with chronic pain. Definitely worth a read. All there books are cheaper to purchase through their website. I also know that libraries can do an interlibrary loan if your local library does not carry it or can order it in if they are not able to access it (more likely).
I have written a small chapter here and my summary is that only you are motivated to see you get better. Only you can figure out what to do and where to go for help. So arm yourself with knowledge. I have read and used many books that I would never have normally read. I challenge folks to chose one thing from here, if you think it is applicable to your situation, and see if you can apply it to your self. Good luck with your journey post-surgery. I hope that you find the answers that you need - not just the ones you are looking for.