Independent Pain Management Download the PDF
The Institute of Medicine recently reported that chronic back pain costs an estimated $636 billion and affects more than 100 million Americans. They outlined the various steps needed to curb this national challenge, including using public health communication strategies to educate sufferers on how to manage their own pain, and advising that healthcare providers tailor care to each individual's experience.
A Silent Source
Management of pain, particularly chronic pain, presents frustrating dilemmas to physical therapists who don't feel comfortable with the treatment techniques needed to effectively address the condition, or find that patients regress to pre-treatment pain and dysfunction levels at return visits. Equally frustrating is the fact that stretching muscle(s) with active myosfascial trigger points (MTP) is futile and sometimes makes pain worse. MTPs, often the source of chronic pain are undetectable on X-rays, MRI, CT scan and EMG, and serum and blood count results are often normal.
Pain referred from MTPs does not necessarily follow dermatomal or myotomal patterns and may give rise to suspicion of symptom magnification by the ill-informed practitioner, who may be unwilling or unable to identify and/or manage. The Use of self-treat tools such as balls, rollers, canes and boards, to alleviate MTP-generated pain is widespread. Prices range from a $1 tennis ball to upwards of $275 for more elaborate equipment. Balls are the most commonly used tools. However their flat contour doesn't allow for pressure application wtih sufficient acuity. They tend to move when lain upon or leaned against, and deeper penetration requires a larger ball, which has an even flatter contour and less acuity of penetration.
A ‘Hands-Free’ Solution
The Tola™ System has been developed with these shortcomings in mind. The user is able to select from three different probe sizes, and heights and angles can be adjusted with various accessories (Tola™ Wedge and Tola™ Rocker) to lie on, lean against, or use as a handheld tool.
Tola™ Point geometry facilitates access of muscles without impinging on bony structures, and while relaxing the area being addressed. Subtle movements of arms or legs away from the site being addressed helps to alter the pressure being applied. The device is easily transported and can be used in the office, at home, or at the gym.
Effective Pain Relief
Marked improvements have been documented after Tola™ System use in patients with chronic back pain, enabling quicker transition to strengthening, stretching, and aerobic activity - which is associated with release of various hormones essential to repair of damaged muscles. One specific patient demonstrated a 27% increase in lumbar flexion and a 533% increase in extension, as measured using dual inclinometry, and he registered 97% to 247% increases in pressure pain threshold at gluteus medius and L4 paraspinal muscles after adding use of the Tola™ System prior to his stretching regimen at home. Another chronic pain sufferer of 20 years - following 9 ankle surgeries - cancelled below knee amputation surgery when MTPs were discovered in the lower limb that, when when released, resulted in near complete pain relief. The system may be used for chronic and acute pain, as well as on muscle spindles or Golgi tendon organs to release tight muscle prior to stretching. This is particularly useful in hypermobile individuals with isolated muscle tightness.
Use of the Tola™ System will assist both the therapist and patient in managing and treating chronic pain, thereby saving on unnecessary care and moving closer to satisfying the goals set forth by The Institute of Medicine.
Dr. Reynolds is the co-owner and founder of Reynolds Rehabilitiation Enterprises, out-patient orthopedic, sports, music and dance medicine practices in Minneapolis and Eagan, MN. He has worked as a physical therapist since 1988 using Maitland, Cyriax, McKenzie and Travell manual therapy techniques, among others and is the inventor of the Tola™ Neuromuscular Release System.
