SALT LAKE CITY — Pile some stress on top of a lifetime of bad posture and the result may be a literal pain in the neck — or the pelvis or the back or some other part of the body.

Pain and misalignment were fodder for physical therapists Susan McLaughlin and Jake Magel, both with Intermountain Healthcare, on Saturday as they fielded dozens of calls on the monthly Deseret News/Intermountain Health Hotline.

Tension, sitting too long and bad posture can be key components of hip pain, McLaughlin told one of several callers who had that complaint. Pain in the hip and the knee both may trace back to issues with pelvic alignment. She said she often screens for tightness and strength.

"I'm so big on posture," she said, noting it is a big component in certain arthritis cases, among other issues.

Not all therapy is the same — and as with other aspects of medicine, treatment may be driven by what the provider knows best or feels most comfortable with, said Magel, who noted Intermountain has tried to standardize physical therapy in an evidence-based-medicine model. It gets complex because not all neck pain, for instance, has the same root. "What we try to do is make the person and symptoms fit into the right classification, then select the intervention that is most likely to benefit them. We are examining and intervening based on current best evidence."

Callers with neck pain were about evenly divided between acute and chronic problems. Those with chronic issues, especially affecting range of motion, are among the most likely to be able to manage their pain well, though it's not a fast process, he said. Degenerative changes are among the most challenging to manage.

The trick with pelvic pain is also figuring out where it originates, because it can come from a variety of sources, including muscle, organs like the bladder and bowel, and connective tissue. Patients may be referred for physical therapy by urologists, gastroenterologists, gynecologists and others. It's a complex region of the body and resolving what's causing the hurt can take some sleuthing.

"I believe my role as a PT is to try to restore balance," she said, including bad alignment in the pelvic region. When muscles are tight, she helps stretch them. When body parts are weak, she helps strengthen them.

The hotline tackles a different topic each month.

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