My scan/image report sounds bad. Does damage = pain?

My scan/image report sounds bad. Does damage = pain?

Damage does not equal pain, this is why scans can be misleading!

Scans can be very useful for diagnostics and to point us in the right direction, but they can also cause worry and unhelpful beliefs that we should be in pain because of damage seen on scans.

What your body part looks like while you are lying in a tube does not correlate well with how someone feels and moves. A lot of people have problems found on x-rays and other scans but have no pain or symptoms at all!!
Below are some great examples of why we don’t need to be getting too worked up about what our scan results are showing, and how with the right treatment and mindset, you can beat your pain!

Intermittent Pain

In most cases, people will describe their pain as having varying intensities, and at times it is not there at all, which is great! This means there are times when your nervous system is happier than the times you are feeling the pain – These “happy” periods can be extended.
In terms of a scan, even when we are in these happy, pain free zones, an MRI or X-Ray will still look the same as when you are in pain, so you can live comfortably and pain free with your scan still looking like it does!


Degeneration is a term used to describe “wear and tear” that our body and its joints naturally experience through living life! Degeneration begins to appear even in our late 20’s (pain free individuals included!).
If you have one sore knee and one pain free, studies have shown that the “good” knee will show just as much degeneration, sometimes more, than the other knee, as they are both the same age and likely to have done similar amounts of work, so why would only one knee be sore if degeneration is the source of pain??


It has been shown that up to 87% of people in their 20’s had disc herniation’s/ protrusions, highlighting that this sort of movement or change to the disc is considered quite normal! Many people live with these things every day and have never had a painful back.  So a disc bulge seen on CT scan or MRI is not a recipe for long term back pain.

 Pinched Nerves

Nerves are very strong, resilient structures, but can be very sensitive when aggravated. They are designed to be stretched, squashed and moved in all directions, so a “pinched nerve” seen on MRI/CT may not be the main source of pain.  We sit on our sciatic nerve all day, and stretch nerves every time we bend and twist, and the majority of the time – no problem.
Whatever our spine looks like on an MRI, chances are it looked like that the day before you had pain as well, as these changes take years to develop, as long as there was not a major trauma or incident.

What all of this tells us is that what we see on a scan may not be the actual cause of your pain.

At Willunga Physio we look at your whole body the ‘whole picture’ to locate the source of your problem.  We check every muscle, joint, action and nerve that may be contributing and fix the cause of the problem.

Ice or heat for my stiff neck?

Ice or heat for my stiff neck?

When we get an injury we all want some relief, but we also want to make sure we aren’t doing any more damage to the area and to know that what we are doing is beneficial.

But what about when you’ve woken up and your neck feels ‘locked’? Every time you try to turn it you get a sharp pain or stiffness. What is best?

Which brings us to the age old question, should I apply Cold or Heat??

What does Ice do?

When cold is applied to an area, it restricts blood flow and causes constriction of blood vessels, hence causing the bleeding of an injury to be reduced, along with any inflammation.  It can be a very effective pain reliever (once you have got over the ‘cold’ bit).

And heat?

Heat application causes dilation of blood vessels and increases the blood flow to a muscle, which can have a relaxing effect and aid in pain relief.

Both are useful and both can provide relief, however it is important to know at what stage to use them and the symptoms to look for that can help you choose which medium to use!

So if you have injured yourself

As a general rule, if an injury is showing signs of inflammation, ie. It is hot, red or swollen, then Ice is recommended as this will reduce the inflammatory process.

Other signs of inflammation can be

  • pain at night or when you settle for the day,
  • throbbing pain, or
  • pain that is a dull ache/throb deep in the area of injury.

Usually inflammation occurs for 2-3 days post injury, so if you roll an ankle, pull a muscle, get a knock or have a definite injury, ice for the first 2-3 days is recommended, using it for 20 min every 2 hours.

For that sore back or neck

Heat is generally used for a more chronic injury, or if an injury has passed this inflammatory stage and is feeling more stiff and tight. Because of the increased blood flow, heat can help relax tight muscles, and with increased blood flow and nutrients to the source, can be a nice way to get some pain relief.

Signs to use heat may include

  • feeling stiff and tight,
  • waking in the morning with tight/stiff areas that improve as you get moving,
  • pains that feel better when you have a hot shower or do some exercises to warm them up
  • general aches and pains that have been there for a long time and haven’t recently been stirred up.
And my locked neck?

If you did something to injure your neck (twisted quickly of jolted it somehow).  Ice is best.  BUT if you just woke up feeling stiff and didn’t do anything to injure it, Heat will help relax the muscles and ease some pain.  As always, if unsure contact your friendly physiotherapist.

To sum it up:

ICE is best if – red, hot, swollen, acute injury (2-3 days), achey/throbbing pain, sore at night when resting.

HEAT  is best if – stiff, tight, feels good when shower or do exercises, morning stiffness, no acute injury.

4 easy tips to ease neck/back pain

4 easy tips to ease neck/back pain

  1. Take a “Smoko”!

THAT got your attention :).  Now, when your work colleagues get up and go outside for a ‘smoke break’, get up and go with them. Be sure to stand ‘up wind’, but a short break, regularly from our seated work posture is the best way to give your neck and back muscles a break.

Walking and rolling your shoulders for a minute gets you out of that static seated posture and gives your muscles a chance to re-charge. Often we work better after a short break anyway!

  1. Buy a good chair!

An easy way to take some tension out of your shoulders is to ensure your office chair is set up correctly. You will need a gas/hydraulic up/down chair to do it. Spend the $$, they are gold.

  1. Adjust your chair

Using the lever that lifts you up/down ensure your seat is high enough that you can drop your hands and shoulders down to the keyboard.

A low seat and the subsequent shoulder shrugging required to get your hands up on the keyboard is an easy thing to change.  Your shoulders will love you.  And if your feet then do not reach the ground you have just found the perfect spot to keep the Yellow pages.

 That other lever on the gas, up/down chairs adjusts the back rest angle, but also and more importantly the angle of the part you are actually sitting on.  Tipping this forward (even as little as 3-4 degrees) throws your weight forward onto your feet, so you sit on your ‘bum bones’ not your tail bone.

N.B. It can take a day or two to adjust but is worth persisting. The lumbar support in new cars also does this, and if all else fails a Lumbar Roll (from your friendly physio) strapped to your seat will help sit you up.


 4. Exercise

Our bodies need movement and different positions but winter is really conducive to sitting on the couch, drinking Milo. A 5 minute walk daily, can really help prevent back pain. 10 minutes a day is better and 25 minutes, Tremendous!  But 5 minutes will do….remember follow those smokers out or walk to the bakery, just get moving! Now would also be a good time to restart the exercises your physio gave you.

Crook backs, and arthritic areas: Ridgway Method can help chronic pain!

Crook backs, and arthritic areas: Ridgway Method can help chronic pain!

Ridgway Method (RM) is systematic approach to physiotherapy, allowing a way of assessing the body to find the “underlying cause” of your condition, i.e. to find out what structure is causing your body to “guard up” and give your body a reason to create the pain and stiffness you are experiencing.


When someone has a chronic injury, it means they have had an initial injury just like any other condition we see, but it has not resolved and has continued to give them trouble for months on end. If an injury has been going on for this long, there is often a lot more of this guarding going on throughout the body,

because your brain understands that the underlying cause has not yet been found and fixed,so it continues to tighten things up and give you pain to make you aware that there is still an issue somewhere in your body that needs addressing!

As we are learning more and more, this issue in the body is quite often in a completely different area of the body to where you are feeling your symptoms. As there is no hard wired nerve or pathway for “pain”, and it is just a creation of the brain to protect us, it may be mapped to anywhere in the body that the brain thinks it will best serve to keep us from doing more harm. So while you may have had this chronic low back pain for years, the pain in your back may just be the body’s best way of protecting an area in your upper back, or in your leg, or even in your arms/shoulders/neck, which explains why having your low back rubbed and treated all these years does not give long term relief, because the issue is not actually in your low back, and your body knows this..

This is where RM comes in...

RM searches your whole body and finds out exactly what structures in your body are stiff, sore, or just not functioning ideally. Any of these dysfunctions within the body have the potential to cause the guarding up and stiffening of the body that we spoke about earlier, which can then lead to pain.

Once we have a list of these dysfunctions, we can then test each one individually to see which one is the primary contributing factor (PCF) to your condition, and when released, lets your body move in the most free and painless way possible.

So when we have found this PCF, and released it, and got your body moving in an ideal way, the brain no longer has a reason to protect that spot, so all of that guarding throughout your body, even if it has been there for 5 years, can let go!

Once the guarding lets go and you are moving freely again, there is no need for the pain “warning signals” so the pain goes away!!