Pain in Professional Athletes - by Armando Villarreal, MD
Dr. Armando Villarreal is a Pain Management Physician at Rehabilitation Medicine Center of New York. He completed his residency at Temple University and his fellowship at Thomas Jefferson University Hospital. His area of interest is neuropathic pain and the use of neuromodulation techniques. Dr. Villarreal is the former... more
Pain in Professional Athletes
Armando Villarreal, MD
Associate Professor
University of Rochester
In my practice as a pain provider, I see a lot of senior citizens (65 years of age and older), who have developed chronic pain for a variety of reasons: osteoarthritis of the spine, nerve damage caused by diabetes and other diseases, cancer, etc), however, I also see a number of young people with similar complaints of back and neck pain, but without a clear cut etiology. Most of these young patients work in physically active jobs or have stopped working due to their symptoms. Often times, we assume that the reason for their pain has to be a condition called fibromyalgia or myofascial pain. However, this is a very simplistic way to look at the overall picture.
What makes the difference between these young patients and professional athletes? How is it that most athletes recovered from whatever injury they have, but these patients spend years trying to return to their normal daily life?
To begin, let’s look at all the advantages that professional athletes have:
1) Salary: this is a major motivational tool. While young adults work in factories and other establishments that pay minimum wage, professional athletes make a large sum of money, which incentives them to return to their duties as quickly as possible (sometimes even against the advice of their trainers and physicians).
2) Fame and prestige: Another great motivational tool. Athletes feed on the fan’s passion for their efforts. When they are not in the field, there is a big vacuum for them. Everyone likes to feel needed; everyone likes to feel special, and athletes are not the exception.
3) Athletes get the attention of coaches, managers, and their physicians in such a way that it reinforces their sense of feeling special. They want to return to the field as soon as possible, because of this. It is their way to thank those who care for them.
Clearly, coming back to our young otherwise healthy patients, they lack all of that. It is extremely difficult for them to return to the same job where they hurt their back without thinking that it will happen again. This is called fear-avoidance, and it is a real problem. Work hardening programs are designed to address this problem, however, there are very few of these programs, and insurance usually denies coverage.
Another difference between athletes and these patients is the lack of support. While athletes literally have a group of providers addressing their needs, young adults are confronted with the reality that they do not have anyone who will listen to them, care for them, or support them. That is where comprehensive pain programs can play a big role. These programs are designed to do what injured athletes received: a group of providers dedicated to addressing their needs. Again, because of a lack of insurance coverage, such programs are hard to find and are inaccessible to the majority of these young patients.
So how can we help? We tried to provide as much of a comprehensive plan as possible given the economic restrains: We count with the help of a physical therapist, pain psychologists, and interventional pain physicians, like myself, who try to come out with “a plan of attack”, keeping in mind patient’s goals and making sure their expectations are in accordance to the limitations.
We will be happy to see our young patients at our facility.
