The Role of Physiotherapy In Pain Management

Pain is the reason why most of us seek help of a physical therapist or any other health practitioner. Pain is very dynamic.. it’s understanding is gross; in respect to psychological pain or physical pain.

Pain was once thought to be an indicator of injury to your body tissues; it is now known that pain also can be a warning signal designed to alert us to potential tissue damage and to protect us from injury… As a result, we, therefore, do understand that feeling pain doesn’t necessarily mean a physical injury has occurred. 

Often we use various words to describe the pain we perceive, such as; sharp pain, burning pain, stabbing pain, or aching, but it is hard to know if you feel pain the same way your friend or family feel it. Meaning it cannot be quantified or measured with any best technology in the world; it’s unique in everyone’s perception. In relation to physical therapy the unique nature of pain you feel, will give your physical therapist some insight into why you are experiencing it.

Traditionally, the period you have been experiencing pain is a significant indicator to a physical therapist. For instance, acute (recently acquired) pain and Chronic (ongoing longer-term) are not the same things. In most cases, the time frame of the pain has limited from doing daily norms. But it doesn’t necessarily mean that the amount of pain you feel is equal to the amount of injury.

Myths about chronic pain

Research shows that pain can be modified and can change for a number of reasons. The latest science tells us that:

  • The amount or the intensity of the pain you feel is not an indication of the amount or seriousness of a possible injury you have sustained. In fact, there may be no injury present.
  • The experience of pain can change; pain felt today does not necessarily have to be the same felt tomorrow.

In most situations every now and then you tend to seek the attention of a health practitioner if you have acute or chronic pain. Sometimes when you’ve attended to it, it resolves you get better… atimes it’s there for months and years; chronic pain… which has now become a global health burden in musculoskeletal disorders (muscles and joint pain).

World Confederation of Physical Therapy (WCPT)…  press release on July 2019 states that; 

Chronic pain is a significant global health burden – with low back pain causing more disability than any other condition. The role of physical therapists in helping people with chronic pain to take control of their condition, increase their activity, and improve their quality of life.

Chronic pain can be associated with a wide range of conditions including low back pain, cervical and thoracic pain, shoulder pain, headache disorders, cancer, fibromyalgia, rheumatoid arthritis, and osteoarthritis.

Physical therapists have quick unique skills on hands on approach and to recommend specific exercise programmes to help relieve chronic pain.

The benefits of using exercise to manage chronic pain include:

  • Maintaining flexibility and movement
  • Improving cardiovascular health
  • Building and keeping muscle tone 
  • Improving mood and general wellbeing 
  • Helping control pain 
  • Increasing confidence to take part in activities
  • Taking back control of your life and reducing your fear

This Dynamic Pain…

WCPT President Emma Stokes said; ‘People who have chronic pain tell us that it can be difficult to get or stay active. But a physical therapist can work with you to suggest activities or a programme that’s right for you. They can help you understand how pain works, reduce your fears around pain, educate you about your condition, encourage you to take part safely in physical activity, build your confidence, help you remain or return to work or participate in activities that allow you to live life the way you want to.’

Physical Therapists role in managing pain doesn’t end in that conner… they go far to enable you manage chronic pain you have gone through for a while, not only focusing on your biological aspect as the cause, but also guiding you through your ‘mind-set’; about the  pain you are experiencing (psychologically) and the extent of limitation at work and with people around you (socially)

Knowledge… ‘tablet’ for Chronic Pain

In almost 70% of chronic pain cases I have handled, the fear of pain is at the spike, for example; say you have been suffering low back pain for years, walked to every doctor, physical therapist around… but it’s not working, still again when you seek further opinion, the doctor recommends you back to a physical therapist. In this instance I tried to ask, “if you understand anything about your condition?”, the answers I do get are, ‘always confusing’ or most don’t know anything about their condition.

This makes you fear even moving or turning in bed, your pain scale of imagination shoots very high every day and in real sense it doesn’t even amount to the pain you have in your low back. But immediately you are being thought, the real thing happening in your low back and how it will be managed, you are also reassured and counselled over, it’s a guarantee… you quickly start responding positively to treatment. This is because, ‘knowledge can break the fear-tension-pain cycle’.

The Approach you Need…

Skilled and experienced physical therapists in their practice will always use the biopsychosocial model approach in their treatment plan. On basis of you understanding what biologically is happening (understanding your condition), how your thoughts influence your well being and the healing process and how it has pulled you out from interacting with friends, family and even workmates. The three aspects are very key to your treatment plan simply because the first ‘tablet’ is your mind-set; “healing does start from the mind” inspite of many years you have been through pain while searching for treatment.

Written by;

Moses W. Katasi

Clinical Lead Physiotherapist 

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