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5 questions to ask about your pain

Treatment for musculoskeletal pains involving your joints, bones and muscles are a little different from treatment for a cold or flu. Often resolving the symptoms such as fever is pretty much the same as solving the problem itself e.g. the bugs are getting terminated! We all know that the better we understand our situation, the better we help ourselves. So here are 5 questions you should ask your doctor or therapist treating you using a sprained ankle as an example.

1) Ask for an explanation for your symptoms. This is a relative straight forward question to find out what exactly is hurting. This is not the same as what's causing the pain, which is the next question. Ask, "Why does it hurt at the outside of the ankle and not the inner side of your foot?" Symptoms: Your ankle ligaments have been stretched and are now inflamed. The initial swelling is a result of your body protecting itself and it part of the healing process.

2) Ask for the diagnosis behind the symptoms. Symptoms and diagnosis are two very different things. Symptoms are 'signs' of injury, while diagnosis is about determining the underlying cause of injuries. Unfortunately, the terms symptoms and diagnosis are often used interchangeably. A collection of symptoms are what points to a diagnosis of a condition. Some conditions like ankle sprains are relatively easy to identify as either they have a few simple symptoms and not many conditions share the same overlapping symptoms. But some conditions, like back pain, can be difficult to determine without undergoing a more vigorous process of elimination and hypothesis or critical analysis. The diagnosis here is an lateral ankle sprain, meaning that the ankle was inverted inwards from the outer edge of the foot beyond its limits, stretching one of the ankle ligaments.

3) Ask if the treatment resolves the symptoms or underlying cause. In the case of ankle sprain, the treatments such as cold compress and therapeutic ultra-sound that reduce the swelling and lessen the pain are simply resolving the symptoms - the inflamed ligaments.

After the swelling has gone down and it is no longer painful to move, your ligaments are still stretched and are longer than what they were before. This leads to reduced ankle stability and proprioception, making another ankle sprain happening again that much more likely

If your doctor or therapist packs you off after getting the swelling down, you have not addressed how to prevent an ankle sprain happening again in the near future. You have only treated the symptoms.

What is needed here is to prescribe a solution to compensate for the lax ligaments such as exercises, taping, supports to treat and manage the underlying cause.

4) How long should the treatments last? This is seems like an obvious enough question and is usually asked. But often the patients ask in order to find out when they will be done with the treatment.

You should also ask this question to collaborate what you observe with what the therapist says should be the improvement schedule, validating the diagnosis.

If the therapist says that the swelling should go down by two treatment sessions and it has not after four, the earlier diagnosis might have to be revaluated or you simply could be slow in responding to the treatment. It's just good to know.

5) Understand what you need to do to manage or resolve the underlying causes. Make sure your therapist know what constraints you face. If you have sprained your ankle playing football, you are not likely to follow your therapist's advice to stop playing football. Make sure that your therapist knows about your love of the game and that you intend to continue playing.

Your therapist can then teach you how to tape or brace your ankle before a game and train you with rigorous ankle proprioception and strengthening exercises.

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