Do You Have A Pain Diary?

September 22, 2020 – We have reviewed in September a lot of different informational topics about pain. We have learned the different types and what it is. We have learned some strategies to help manage it. Next, we need to learn how to track and understand our own pain. This is especially important when we are having pain some days and not others. A pain diary can help you and your healthcare provider have a better understanding of what things are causing issues for you.

What to put in our pain diary?

  1. We want to keep track of when our pain occurs and at what intensity. Often a scale of 0 to 10 is used. A score of “0” is no pain and a score of “10” is so much pain you feel like you need to go to the ER.
  2. We want to track what type of pain we are feeling. Burning, sharp, throbbing, stabbing, etc, are all descriptive words you can use.
  3. We want to track what our emotions are at the time of our pain.
  4. We want to track how long the pain lasts.
  5. We want to track what makes the pain better. These are non-medication pain improvers such as position, ice, heat, etc.
  6. We want to track if we take any pain medication for our pain. Then we want to track what our pain level is at 60 minutes after we have taken the medication.

Once we have several, incredibly detailed entries in our pain diary we want to share that information with our medical providers. This can be extremely useful in figuring out what method of treatment we will start with in order to help you manage, improve, and hopefully eliminate your pain.

If you are in pain, follow these simple steps. First, start to record a pain diary. Second, call us in Louisville at 402-234-3333 or in Plattsmouth at 402-298-4747 to set up a free consultation to discuss your pain and your pain diary. Let us help you find the next step to help you alleviate your pain as efficiently as possible!



Biggest Mistakes You Can Make When You Are In Pain

September 8, 2020 – Last week we learned about what pain is and what are some of the different types. Now that we understand those items, we can begin to look at how to deal with pain. There are some misconceptions about how we should deal with pain. Today we will look at those misconceptions and work to get a better understanding of a positive way to deal with pain.

Here are some common mistakes:

  1. Thinking it will go away: Trying to give it some time to get better or self-treating with over the counter pain meds can make it worse. If you pain is not improving in a few days or does not completely improve in a few weeks, then get in to see someone. This could be your primary care physician, a specialist, or a therapist. Often the sooner you start treatment after the pain starts the quicker it will heal.
  2. Avoiding exercise: Often bed rest is the worst thing you can do for pain. Starting to get moving can be the first step to helping to alleviate the pain. This could be some simple stretches or going for a short walk. If you are afraid you could make it worse consult your physician or therapist for their advice and recommendations on how to start to increase your activity.
  3. I need surgery now: Surgery is not the cure all answer for every problem. Often surgery brings in more risks, such as infection, complications, or just being ineffective. An ineffective surgery still requires healing time and now you are trying to work on more than one problem. Often, insurance will require more conservative treatments prior to approving surgery. Use prescribed medications, therapy treatments, and DME products prior to seeking surgery.
  4. You do not talk about being depressed: Pain can cause depression. Pain that is present daily affects our lives constantly. If you are adjusting what and how you do things daily due to pain, avoiding social events due to pain, or just staying in more due to pain, all these issues can cause depression. It is normal to be depressed and it does not mean it is permanent. Talk to your physician, friends, or spouse about how you are feeling.

Recognizing these mistakes can help you understand how you are feeling about your pain and how it is affecting you. Now that you have a better understanding of what pain is, what types of pain there are, and how you can avoid making mistakes due to your pain you can begin to work on making your pain better. Starting next week, we are going to explore some options for improving you pain.

If you are having pain and feel like these are some of mistakes you are making please call us at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth to set up a free, no obligation consultation to discuss your pain. Let us help you get on the right track for your needs!



Are you in pain?

September 1, 2020 – Unfortunately, at some point in our lives we are going to experience pain. It could be pain from a loss, pain due to an injury, or several other types of causes. We need to understand what pain is and where it is coming from to treat it and help it get better.

There are 3 basic types of pain: nociceptive, neuropathic, and “other”.

    1. Nociceptive: This type of pain is the most common type. You feel it with strains, bug bites, stubbing your toe, etc. This type of pain can change with positions, movements, or loads.
    2. Neuropathic: This type of pain comes from damage to the nervous system. This type of pain can include sciatica, MS, alcoholism, etc.
    3. Other: The other type of pain can be a result of the combination of the first two types or be something completely different, such as fibromyalgia.

There are other ways to try to classify pain. These include:

    1. Acute: New and sometimes sudden pain.
    2. Chronic: Pain that has been around for a while. Most likely comes from chronic pain.
    3. Breakthrough: Sharp bouts of new pain that can happen with certain movements, activities, or as pain killers are not as effective.
    4. Nerve: Caused by damage or stress to a nerve. Often feels like a zinger, burning, or achy pain that is not relieved with normal pain meds.
    5. Referred: Often caused by an internal organ or other non-musculoskeletal structure that gives us the sensation of the pain happening in a different area of the body.
    6. Phantom: Occurs when our brain feels pain in a part of the body that has been removed.

Having a better understanding of what pain is, where it is coming from, and how it is affecting you can make it easier to treat. At Witte Physical Therapy we know all pain is different and affects everyone differently. We will work hard to understand how your pain affects you and then build a program that is specific to you to help you improve your pain as quickly as possible. Call us in Louisville at 402-234-3333 or Plattsmouth at 402-298-4747 to schedule your free consultation today and let us help you get on the road to being pain free!



Sit Up Straight!

August 18, 2020 – We have spoke about posture several times before. Its role in shoulder pain, its role in how your child carries their backpack, and today its role in their attentiveness at school.

Good posture leads to a decrease chance of injury and less energy being spent on muscles and joints that must be supported differently in a bad position. Good posture leads to an environment that makes it easier for them to see the front of the classroom, hear the teacher, and focus on what they should be focusing on.

Graphic design of correct or incorrected posture at the school desk.... |  Download Scientific Diagram

How can parents and teachers make sure that good posture is maintained throughout the day? Feet should be flat on the floor and hands and elbows resting comfortable on the desk without affecting shoulder height. Children should be given breaks throughout the day to get up and move. During floor time allow the children to lay on their stomachs with the heads in their hands propped up by their elbows. This allows for an extension biased posture instead of the flexion biased posture they are kept in at their desks all day. Posture checks should be done quarterly as kids will grow throughout the year.

If your child continues to have pain or issues with their posture call us at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth to schedule a free consultation to get them back on the right path to success in the classroom.


Active and Consistent Nightly Routines for your Child

August 11, 2020 – How can we get our kids the rest they need and in the right routine for them to be ready for school? This is a question a lot of parents ask as they start to prepare to get back into a routine after months away from school.

A lot of us probably do not realize how important sleep is. Sleep is the body’s best time to repair itself after a long day of wear and tear. Sleep helps to prevent many different diseases, including heart disease. Sleeps helps to improve concentration and decrease excessive eating. Don’t those sound important?

Now that we know how important sleep is, how do we get our kids in a routine? It is important to establish a bedtime at night and start the bed routine no more than 30 minutes before that time. If bedtime is 9pm, then the bedtime routine should start around 830pm. Kids should start to pick up their toys and games to clean up their area from the day. Remember you are in charge. Children will find out that they can prolong bedtime by asking for more books, a glass of water, having their stuffed animals just right, or about anything that is going to require you to be with them for longer. Set your routine and stick to it. Pick up toys, put on pajamas, brush your teeth, pick out a book to read, and then give them a kiss goodnight. Sticking to the routine will help it to become their new habit.

If you are having issues establishing this routine or seeing issues related to children not getting enough sleep call us at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth for a free consultation on what your next steps should be.



What to do to avoid a heavy backpack

August 4, 2020 – As of today the plan is that our kids get to go back to school. They get to go back to a routine, to see their friends, and to carrying backpacks. This last point becomes even more important this year. The kids will have to carry all their items in their backpack to the classroom each day. This means that these back packs will likely be heavier than normal, but how heavy is too heavy.

Research states that a backpack should not weigh more than 20% of your body weight, and preferably be closer to 10%. That means for a 60-pound grade school child, their backpack should no weigh more than 12 pounds, and should be closer to 6 pounds. It does not take long to get to 12 pounds once you get a few books, pencils, and a lunch in that backpack.

If a backpack is too heavy a child may have to compensate. They may lean forward while walking, hike up their shoulders to help support it, or arch their back. All of these can lead to back, neck or shoulder pain. They may prefer to only use one shoulder strap because it looks better or is quicker, but this extra weight on one side of the body can cause an imbalance in the muscles or an imbalance that may cause a fall. Both of these positions can lead to poor posture, which many of our kids already have due to technology (see previous blogs).

The straps of a back are carried across your clavicle. This is an area of the body where lots of nerves and vessels run. Compression of these areas can cause issues down our arms in the form of pain, temperature and sensation changes, and weakness.

Ways to help with these issues can be the following:

  • Using a lighter weight backpack
  • Helping your child organize to minimize the amount they need to carry
  • Making sure we are lifting with our legs and putting the backpack on and taking it off safely
  • Help them to make sure the backpack is fitted properly
  • Educating them on what “too heavy” is

These simple steps can help minimize the risk of any pain for your child. If these steps don’t work for you or if you have questions about what you have read please contact us in Louisville at 402-234-3333 or Plattsmouth 402-298-4747 for further information or a free consultation!




How to Sleep with Shoulder Pain

July 28, 2020 – One of the more frustrating aspects to having shoulder pain is not being able to sleep. Side sleepers find this especially aggravating. However, if your shoulder pain is really bad or you have some shoulder instability sleeping in your bed can be downright painful. Many people move to a recliner to try to get some rest. Below are some helpful hints to trying to get a good night’s sleep with shoulder pain.

    1. Avoid sleeping on the shoulder that hurts. Trying laying on your other side, back, or stomach with your shoulder in a comfortable position.
    2. Use more pillows to help prop your shoulder in a comfortable spot or to stop you from rolling back onto your hurt shoulder.
    3. Sleep with your arm held close to your body by keeping your arm inside of a t-shirt instead of putting it through the arm sleeve.
    4. Stay active during the day to promote better blood flow. This blood flow can help with healing. But avoid being too active and causing increased pain and inflammation that can manifest at night.
    5. Use medication as needed. Make sure you are taking what your doctor or pharmacist allows for your needs.Try to maintain the same sleep schedule. This includes what time you go to bed, what avoid eating or drinking before bed, and what time you usually wake up.

If these strategies do not do the trick for you give us a call at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth for a more complex consultation to see what your next steps should be.



What are the Different Types of Shoulder Pain?

July 7, 2020 – A common problem a lot of us get is that our shoulder hurts. Outside of back pain, shoulder and knee pain are the next more common ailments we may experience. In this month’s blog series, we are going to dive deeper into shoulder pain.

This week we are going to investigate what the different causes of shoulder pain could be. But first we must understand why these things can happen to our shoulder. The main issue is that our shoulder has so much mobility in it that it is not that stable. We have all the motion we could want in our shoulder which allows for us to do a variety of things with it. However, to have that much motion we cannot have a lot of bony structures in our way. This creates little static stability, meaning that our ligaments and tendons have to work extra hard to keep our shoulder joint in place and avoid dislocation.

normal shoulder anatomy

The different types of shoulder pain are:

    1. Bursitis: Inflammation of the bursa sacs that protect our ligaments and tendons from rubbing abnormally on bones. If this rubbing becomes abnormal or excessive these sacs can get inflamed making shoulder movements painful.
    2. Tendonitis: Inflammation of a tendon in the shoulder that causing pain. The most common tendons are the four rotator cuff tendons and the long head of biceps tendon.
    3. Impingement: Caused by the acromion of your shoulder blade putting pressure into the tendons of your shoulder. It can be caused by a bony abnormality or tendonitis.
    4. Tendon Tears: Often called a rotator cuff tear. This a tear of a tendon of the rotator cuff that helps to provide dynamic stability to the shoulder. These tears make it difficult to do things overhead or to move your elbow away from your side. The long head of biceps can also be a common tendon tear.
    5. Instability: Caused by a variety of factors include tendon or ligamentous issues. Often leads to positions or situations where it feels like your shoulder is going to dislocate.
    6. Arthritis: As discussed in May, arthritis is a condition where the cartilage on the ends of your bone deteriorates causing the two bony ends to rub together. This is often painful and makes any motion difficult.
    7. Fracture: This is caused by a broken humerus or scapula.

The good news is that many of these conditions can be treated and improved on without surgery. Not every rotator cuff tendon tear requires surgery. If you are having shoulder pain give us a call at 402-234-3333 in Louisville or 402-298-4747 in Plattsmouth to schedule a free consultation with a therapist to learn more about what is going on and what your next steps should be to help your pain improve.


How Can I Make Uncle Arthur Stay Away?

May 19, 2020 – The last two weeks we have learned what arthritis is and what the different types of arthritis are. Now that we know these grim facts a lot of us may be asking one big question. What can we do to prevent an unwanted visit from “Uncle Arthur”?

Some of the risk factors that we associate with the different types of arthritis are not preventable. These include family history, age, and sex. We know that if we have a family history of arthritis and/or are wiser in our years we are more likely to get arthritis. If we are female, we are more likely to get rheumatoid arthritis and if we are male then we are more likely to develop gout.

However, some factors can be controlled. First, our weight plays a big role in the development of arthritis. The closer we are to our ideal weight the less stress our joints will endure daily. This will cause the wear and tear on the cartilage in our joints to be at the lowest possible. Previous joint injury also plays a role in the onset of arthritis. If we can protect our joints by being as strong as possible and participating in situations that we can control our chance of having a joint injury is decreased. Unfortunately, things happen and even an ankle sprain can cause arthritis to start to set in.

Osteoarthritis Risk Factors

At Witte Physical Therapy and Witte 24/7 Wellness we have the expertise and the programs to help you manage some of the risk factors that could cause arthritic issues in the future. You can reach out to us to start your therapy or wellness journey and we can develop a plan that is personalized to what you need to reach your goals and lower your risk. Call us in Louisville at 402-234-3333 or Plattsmouth at 402-298-4747 for a free consultation to assess and discuss your questions and options about arthritis issues.

Your Witte Physical Therapy team

#homegrown #backtolife


Uncle Arthur comes in many forms!

May 12, 2020 – Last week we discussed what arthritis is and now we need to understand what types of arthritis could affect us. Not all our “Uncle Arthur’s” are the same!

Osteoarthritis: This is the most common type and is the type of arthritis that most of us think of. It is usually localized to one joint at a time (but it can be present in more than one joint) and involves the breakdown the cartilage found inside the joint. The damage caused can be managed conservatively and/or surgically, but once the damage has occurred it cannot be reversed.

Rheumatoid Arthritis: The is the second most common type of arthritis. It is an autoimmune disorder that causes chronic inflammation in several joints throughout the body at the same time. It is systemic and causes a break down of the bony lining causing pain and deformation in the smaller joints of the body, like your hands for example.

Picture of Osteoarthritis(from

Several other types of arthritis include ankylosing spondylitis, psoriatic arthritis, gout, etc. These are much less common and can be managed either conservatively and/or surgically.

We would also like to wish a Happy Mother’s Day to all mothers out there. We are especially grateful for the mothers of our staff and patients and our staff and patients that are mothers. We are very, very thankful for all that you do!

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Your Witte Physical Therapy team

#homegrown #backtolife