Do you or someone you know suffer from some form of chronic musculoskeletal pain? In my 30 years of clinical experience the common answer to this is a resounding YES. We all know someone who suffers from chronic issues only to be told by their doctor “that nothing can be done” or “you will have to learn to live with the pain”.

Dr Orazio Trevisan is the owner and founder of Contemporary Healthcare and he uses a whole body holistic approach in the diagnosis and treatment of  chronic  pain at the Brookvale practice. He has people come to see him from all over Sydney as well as regional centres for treatment of their chronic pain.

“In my experience, most people with chronic pain can be helped. The key is to address not only a persons symptoms, but to assess and treat the underlying causes.”

Let me give you some examples of chronic pain that I see in the Brookvale practice:

• A person presents to the clinic with chronic lower back pain, they have seen a number of practitioners who have given them little or no help. Generally the lower back has been the main area of focus in treatment. It needs to be said that the lower back pain may simply be a symptom of an underlying problem somewhere else.

In the diagram below we can see the muscular connections between the lower/ upper parts of the spine and the shoulders. The chronic lower back pain that the person is experiencing may be due to a shoulder problem on the same or opposite side of the body. The shoulder problem can lead to an increased work load in the lower back ultimately leading to chronic pain. In this case then, the shoulder needs to be treated along with the lower back in order to get rid of the lower back pain.

• In this next example, a person presents to the clinic with a chronic knee problem. This person has again seen many different practitioners with little or no help. The focus of treatment has been the knee. Again in this case the knee pain may be only a symptom of  problem somewhere else such as the foot or the hip. If we look at the diagram below, we can see the intimate relationship between the hip, knee and foot. There can be chronic tightness in the foot or hip, biomechanical dysfunction in how the foot or the hip moves or simply a lack of stability in the foot or hip due to injury or overuse. The foot or hip dysfunction can then lead to the knee having to work a lot harder which can than result in chronic pain. In this case the foot or hip would need to be treated along with the knee to resolve the chronic knee problem.

These are just 2 common examples that I have seen repeatedly over the last 30 years. There are countless more examples but the take home message is see a practitioner that looks at whole body function and has a holistic approach to treatment.

At Contemporary Healthcare Brookvale, the latest forms of treatment are offered to achieve the most outstanding results for patients. The 3 most effective treatments of choice for chronic pain which set Dr Orazio apart from other clinicians and other practices are;

• • • ESWT (Shockwave Therapy)
    • IASTM (Instrument Assisted Soft Tissue Mobilisation)
    • ART (Active Release Technique)

These treatments are used in combination to;

• • • Break down scar tissue
    • Improve functional movement
    • Improve neuromuscular co-ordination of the affected area

Dr Orazio Trevisan has over 30 years of clinical experience and specialises in dealing with complex issues which lead to chronic pain. If you have any questions regarding treatment for chronic pain or if you want to make an appointment, please call the Brookvale practice on 9971 4408.

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A large number of us start our new exercise program with either an acute (short term) or chronic (long term) injury, one of the most common being an injury to the shoulder.

Sound familiar? I see a huge number of people in my clinic who have exactly that, shoulder pain that has been affecting them for a long time. Some people do seek help and treatment, but a large number of people procrastinate and don’t get a proper diagnosis and treatment only to end up under the surgeon’s knife in their 40’s, 50’s and 60’s.

Most shoulder problems involve some form of damage to the rotator cuff muscles leading to chronic instability and pain in the shoulder. This can often have an adverse effect on other areas of the body such as the neck, mid back, lower back, elbow and wrist.

The majority of shoulder problems can be treated and managed very effectively through Chiropractic care.

Short term management usually involves treating the specific part of the shoulder which is damaged and causing pain. Some of the more common areas involved in treatment are the rotator cuff muscles (such as the infraspinatus, supraspinatus and subscapularis muscles) as well as the shoulder capsular ligaments (most commonly at the front of the shoulder).

Long term management involves addressing the underlying issues that caused the shoulder to become damaged and dysfunctional. These can include;

• Spinal problems in the neck, mid-back or lower back (including pain and stiffness),
• Jaw dysfunction
• Chronic stress (this can lead to shoulder damage either through postural changes or changes in nervous system function)
• Poor diet, leading to inflammation in the gut and joints
• Muscle imbalances between the front and back parts of the body (upper, lower crossed syndromes)
• Poor posture,
• Poor core strength
• Poor flexibility

How many of you reading this article have one or more of the problems listed above? Having the shoulder properly assessed and being given a proper diagnosis and management plan is paramount as early as possible. Managing the injury properly along with the underlying issues that lead to the shoulder injury will lead to a much better outcome, saving you from a lot of long term pain, not only physically but in the hip pocket.

Dr Orazio Trevisan (Chiropractor)

BSc (UNSW). MChiro (Macq Uni).

PGD Chiro Sports Science (Macq Uni).

MSc Chiro Paediatrics (Uni of Wales).

Certified Applied Kinesiologist

NET (Neuro Emotional Technique)

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