Physical Therapy for Chronic Pain
Can Physical Therapy Treat Chronic Pain?
Seeking Relief from Chronic Pain?
If you have been experiencing chronic pain and are looking for solutions, you are not alone. Chronic pain may affect as much as 40% of the population worldwide (Cohen et al., 2021) and those living with chronic pain experience effects ranging from negative social-emotional and physical impacts to heavy financial and psychological burdens. In this article we will discuss how chronic pain differs from acute pain, how it impacts an individual’s life and how physical therapy may be beneficial to alleviate some symptoms of chronic pain.
HOW DOES CHRONIC PAIN DIFFER FROM ACUTE PAIN?
Pain is the body’s method for recognizing a stimulus is injurious or potentially injurious to our tissues. Without pain, you would not know to lift your hand quickly off of a hot stove top or recognize that you should seek care and protection for a broken bone. Without the ability to perceive pain, serious injury or illness would occur possibly without seeking treatment.
Acute pain occurs in response to an injury or irritation to the body’s tissues. It can range from mild to severe. As the tissue heals we expect this pain to lessen, a sign that the tissue is becoming more healthy and recovered. One hallmark of acute pain is that it is generally short-lived, typically not lasting more than 3 months. Physical therapy typically treats the area of injury and the pain level will improve.
Chronic pain, on the other hand, is pain that lasts more than about 3 months. It can be localized but may also be more widespread. Sometimes chronic pain can develop from an acute condition in the case of an injury or surgery that does not heal well. In other instances, the pain may result from an underlying medical condition.
One hallmark of chronic pain syndrome is that unlike acute pain, chronic pain often occurs independently of actual tissue injury or irritation. This does not mean it is not real but indicates that the brain is incorrectly interpreting non-harmful or non-injurious body signals as evidence that there is a threat to the body. This misinterpretation can keep someone in pain well past normal tissue healing times as the brain remains on “high alert.” Many people with chronic pain fear movement and exercise because they assume that their experience of pain is truthfully alerting them that their tissues are being injured where in many cases (though not all), the pain centers of the brain have become oversensitized to normal everyday sensations.
WHAT ARE THE CONSEQUENCES OF CHRONIC PAIN?
While pain or discomfort may be the hallmark of chronic pain syndrome, many chronic pain sufferers find they develop more systemic symptoms over time. High levels of fatigue and deconditioning are common with chronic pain disorders and may be tied in with disturbances in sleep. Muscle aches, stiffness, burning or aching pain are also common. Mood problems such as depression, anxiety and irritability are often seen with chronic pain as well and all of these symptoms can contribute to difficulties completing daily tasks.
Chronic pain is one of the leading causes of disability and can have ramifications far beyond living with a high level of daily discomfort. It can have negative impacts on personal relationships and self esteem, and the ability to work and afford adequate housing (Cohen et al., 2021). Addressing chronic pain can lead to improvements in all of these areas leading to a global improvement in quality of life.
WHAT ARE SOME CONDITIONS THAT CAN CAUSE CHRONIC PAIN?
Chronic pain may originate from an injury or as a result of another medical condition but it is important to recognize that chronic pain is considered a disease in and of itself and not merely a symptom of another condition. Physical therapy can help address symptoms of chronic pain originating from many sources. Some conditions that may be associated with chronic pain are listed here:
-Acute injuries: In some instances chronic pain can originate from an acute injury. In this case the pain persists despite healing of the original injury.
-Cancer: localized tissue or more widespread nerve damage from cancer treatments can cause chronic pain symptoms.
-Low back pain: chronic low back pain can be caused by many triggers, both traumatic and nontraumatic.
-Headaches: chronic headaches can interfere significantly with one’s ability to work, go to school and take care of necessary daily tasks.
-Complex Regional Pain Syndrome: a form of chronic pain that typically affects the arm or leg, CRPS can develop after an injury or surgery and lead to severe and ongoing pain.
-Arthritis: Loss of the smooth and cushioned joint cartilage can lead to chronic pain, stiffness, inflammation and difficulty moving the joint.
-Fibromyalgia: Pain in multiple tender points as well as fatigue, trouble sleeping, and memory difficulties are classic signs of fibromyalgia.
-Neuropathies: damage to nerves which can cause burning, aching or weakness.
-Diabetes: diabetes can cause long term damage to nerves that can result in chronic pain.
-Limb amputation: after amputation chronic pain can develop as “phantom pain” experienced as though the amputated limb were still present and hurting.
HOW CAN PHYSICAL THERAPY TREAT CHRONIC PAIN?
A personalized and multimodal approach to chronic pain is most effective. Physical therapy may be only one aspect of an integrative treatment approach to your pain but conservative approaches like physical therapy can help improve symptoms of pain, deconditioning, muscle stiffness and more. Reprogramming the nervous system to move out of a “high alert” state so that you can move without pain is an important goal of physical therapy. While a physical therapy program is always individualized, the program may include:
Manual therapy: Manual therapy is a hands-on manipulative type of physical therapy that your physical therapist can use to reduce areas of pain and discomfort. This may include passive mobilization or manipulation of joints or mobilization of soft tissues, for example.
Postural re-education and body mechanics training: learning to move well can be an important step to managing chronic pain. By learning to adjust your posture and move in an efficient and safe way you can perform more activities with less pain.
Graded exercise: It may be scary at first to think of exercise as an appropriate treatment when you are experiencing chronic pain but regular participation in an exercise program has been shown to be more effective in improving function than the reduction of pain itself and can improve sleep and reverse deconditioning (Cohen et al., 2021). Rather than just prescribing general exercise, physical therapists will prescribe a personalized exercise program to target any specific impairments in the musculoskeletal or neuromuscular systems that may be contributing to your symptoms of pain. Relearning non painful movement is an important part of a physical therapy exercise program for chronic pain.
Education: Understanding the mechanics and physiology of chronic pain is an important first step in treating it. Education may also include ways to modify your activities to support your goals for physical therapy and how to use assistive devices or adaptive equipment.
IT’S NEVER TOO LATE TO GET STARTED
Whether you have been experiencing chronic pain for some time or you are sensing that your painful symptoms may soon become chronic, our team at Evolve PT is here to help. We will take the time necessary to get to know you and your story and work with you to develop a plan to address your chronic pain and help you to get back to the activities you enjoy.
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About EvolveNY-
Brooklyn's Premier Holistic 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.
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