Physical Therapy and Pain Management

Physical Therapy and Pain Management

Pain is primarily a protective mechanism of the body, it is our body’s way of telling us that there is something wrong. It can feel sharp or dull, it can come and go or be constant. If you have never felt pain, then you might be at risk of hurting yourself or that you may never be aware if there’s something wrong with your body. You can experience pain in one area of the body, but can also feel it in various parts at the same time. Physical Therapy is a recommended alternative by doctors instead of solely relying on medications as it eliminates pain through movement, exercise and body awareness. 

What is Pain?

There are two types of pain, acute and chronic. Acute pain is pain that comes quickly, can be severe but goes away immediately when the initial underlying cause is eliminated. It is usually because of an initial injury, sickness or disease, or inflammation. This is easy to diagnose and should last in most cases, 3 to 6 months. After acute pain goes away, you can go on with life as usual. However, acute pain can also lead to chronic pain. 

Chronic pain is one that persists even when the initial injury is healed. This usually lasts longer than 6 months. Chronic pain can have debilitating effects and can influence every aspect of an individual’s life. It can affect a person physically, emotionally, and/or mentally. Sometimes, this type of pain becomes apparent even when there is no past injury or initial damage. Chronic pain is often times difficult to diagnose because of numerous contributing factors. For example, a patient is experiencing severe back pain. His back pain can be a result of the poor posture he assumes when at work, poor lifting techniques at the gym, or maybe he has un-diagnosed scoliosis. Chronic pain can also be a sign of a disease such as osteoarthritis, rheumatoid arthritis, or fibromyalgia. 

A  closer look on how pain works...

Pain management is largely a part of physiotherapy. It is often the first step of treatment. Before we discuss how physical therapy can help with pain management, let’s understand how pain works and why it can persist.

When you are injured or develop a painful diagnosis, the nerves in your body will send information to the brain about the affected area. The brain then analyzes this information and classifies if this pain means there is a threat to the body or not. If the pain signal means that there is a threat, the brain will send signals to protect your body. For example, when your finger touches a hot stove, your brain will immediately send signals to tell your arms to withdraw your hands. This protects you from getting hurt. 

When pain becomes constant, your brain and nervous system switch into “high alert” mode making your body and extremities highly sensitive. The nerves and cells in the rest of your body becomes highly sensitive too that even a soft touch or any other gentle kind of stimuli is perceived by the brain as pain that poses a threat to the body. This mechanism continues in a cycle even when the initial cause has healed. 

Common Causes 

Acute pain comes in quickly and has a specific source. This is usually because of an injury such as a bone fracture, muscle strain, or ligament sprain. You can also feel this type of pain after surgery, get sick, or when you get into an accident. 

Chronic pain is present even when there is no obvious damage to the body. Some common causes of chronic pain are arthritis, cancer, nerve damage, and fibromyalgia. Some factors like bone and joint malalignment, muscle and soft tissue tightness, and weakness such as those found in lower back pain patients, can contribute to chronic pain. 

How Can Physical Therapy Help?


The goal of physical therapy with pain management is primarily to find and fix the source of the problem, instead of just treating the symptom. Physical Therapists will use a number of treatment strategies to help you manage your pain. 

Treatment Modalities. Modalities make use of electrical, thermal, or mechanical energy that can influence physiological changes in the body. A Physical Therapist may use electrical stimulation to help numb the painful area. He can also choose to use either a hot or cold compress to help lessen your pain. Another machine he can use is the ultrasound which generates sound waves to create heat inside a muscle or joint. These modalities are used in conjunction with exercise and other procedures to alleviate pain. Modalities can relieve pain, improve blood circulation, reduce swelling and muscle spasms. 

Manual Therapy. Your Physical Therapist will do all the hard work in this part of your session. Manual Therapy is a specific, gentle, hands-on approach in which your Physical Therapist will try joint mobilization or manipulation to improve your alignment, increase range of motion, and consequently improve your symptoms of pain. 

Exercise. The treatment modalities and manual therapy techniques are usually used to prepare your body for exercise. Your Physical Therapist will teach you stretching and strengthening exercises to help your body move with ease and comfort. This can be quite challenging but these are graded-exercises and specifically tailored for your individual level and needs. Exercising even just for 30 minutes everyday can help you improve your posture and movement. Being strong and flexible will reduce the strain and stress on your body, therefore decreasing your pain as well. 

Your Physical Therapist will also teach you about pain in general. How it occurs, and what you can do to manage it at home. They will also teach you a home program which consists of exercises that you can safely perform independently. Lastly, your physical therapist will also teach you proper body mechanics. This will help you move about your surroundings in a safe and correct way, such as how to lift a bag of groceries to prevent lower back pain or how you should sit in front of your desk to prevent neck and shoulder pain. 

The Takeaway...

Physical therapy Pain-Management-

Always remember that pain is a normal and vital part of our life since it helps us protect our body. However, we must also learn how to manage pain. It is important that we be able to address pain while it is still “acute” and stop it from progressing to the “chronic” type which more or less prevents us from living our best lives. Pain medications are appropriate for some cases, but they just mask the pain and do not address the source of the problem.

For sure, your Physical Therapist will work with you in figuring out what strategies would be best for you to manage your pain. 

About Evolve Physical Therapy in Brooklyn, NY-

Brooklyn's Premier Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!