If you live with chronic pain you probably dream of a life without feeling pain at all when in reality, that life would be filled with its own challenges. 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. Serious injury or illness would occur without taking any steps to treat it as you may not recognize its existence.

Acute Pain

Acute pain occurs in response to an injury or irritation to the body’s tissues. It can be mild, for example when you get a papercut, to severe, for example after you broke your leg. As the tissue heals we expect this pain to lessen, a sign that these tissues are 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 affected or contributing areas and the pain improves.

Chronic Pain

Chronic pain, on the other hand, is pain that lasts more than 3-6 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.

Chronic Pain Syndrome

One hallmark of chronic pain syndrome is that it often occurs independently of actual tissue injury or irritation. This does not mean it is not real but indicates that the brain is interpreting non-harmful or 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 CHRONIC-PAIN ASSOCIATED CONDITIONS CAN PHYSICAL THERAPY ADDRESS?

Conditions sometimes associated with chronic pain are as follows:

-Cancer: localized tissue or more widespread nerve damage from cancer treatments can cause chronic pain symptoms .
-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
-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.
-Headaches: chronic headaches can interfere significantly with one’s ability to work, go to school and take care of necessary daily tasks.
-Low back pain: chronic low back pain can be caused by many triggers, both traumatic and nontraumatic.
-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.

IS IT NORMAL TO EXPERIENCE MORE THAN JUST PAIN?

For those living with chronic pain syndrome, they often experience more than just pain. While living with pain is enough to interfere with one’s quality of life, many chronic pain sufferers find they develop more systemic symptoms such as these:

• Fatigue
• Muscle aches
• Sleep disturbances
• Mood problems including depression, anxiety, irritability
• Burning muscles
• Aching or burning pain
• Stiffness
• Difficulty completing daily tasks

WHAT PHYSICAL THERAPY TECHNIQUES ARE USED TO ADDRESS CHRONIC PAIN

As mentioned above, my team and I will create an individualized treatment plan based on your unique presentation and the findings of our exam but here are some treatments commonly used to manage chronic pain:

• 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.
• 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.
• Strength and flexibility training: Graded exercises to improve muscle strength and overall flexibility will be prescribed to meet your current abilities. Having adequate strength and flexibility around joints, muscles and other tissues can help reduce symptoms of pain and help you feel more capable of moving and performing daily tasks
• Education: both understanding the mechanics of your pain and how things that you do in your daily life may be helping or exacerbating your symptoms is an important part of your physical therapy program. Our goal with education is to help you understand your condition and empower you to manage it well in the long run.