Physiotherapy and Chronic Pain

How should we understand pain?

Pain is something everyone experiences, every day.  When we reflect on instances of pain, they tend to come quickly and pass quickly.  Often, pain makes very good sense to us- we bump or injure ourselves in some way, pain alerts us to this, we protect the injured area and the pain goes away.  We call this short-lasting pain, ‘acute pain‘.

Pain can also become long-lasting and we call this ‘chronic or persistent pain‘.  Chronic pain is pain that lasts for three months or longer, on a mostly continuous basis.  Sometimes chronic pain is due to ongoing injury or illness affecting the body’s structures and tissues.  For most people experiencing chronic pain however, there is no evidence of continuing injury.  A simpler way to think about chronic pain, is where pain exists after healing has finished.

Chronic pain can be experienced in any part of the body.

Causes or Contributors of pain?

In the last few decades, we have come to understand pain through the biopsychosocial lens.  This means that the experience of pain comes not only from what is happening in our body but also from our mind, as we interpret and react to the pain within a social context. 

This helps to explain why chronic pain often exists when the body’s tissues have healed.

This does not mean that pain is ‘in your head’. If you experience pain, it is real!  Rather, it suggests that all contributing factors, including mood and anxiety levels for example, need to be evaluated to assess why your pain continues.   

Throughout our lives, our nervous system changes and adapts to help us learn from and deal with different experiences- this is called neuroplasticity.  Sometimes, however, this normal process of adapting leads to a ‘sensitised state’, where small triggers to the body create a large pain response.  Recent evidence shows that this is what occurs in many causes of persistent or chronic pain.  It reminds us that we need to look further than what ‘damage’ might exist to the body’s structures and tissues to determine why you are experiencing pain.

The immune system is also an important controller of the pain system, meaning that health and lifestyle are strong influencers of pain.  Pain frequently reduces our quality of sleep, which can make life tough, and poor sleep, can in turn increase our pain.

How can physiotherapy help?

Our physiotherapists will conduct a thorough assessment of the possible contributors to your pain experience.  These may include the strength and flexibility of your body, your goals and personal situation, and the understanding and expectations you have regarding your pain. 

Every person with chronic pain is different in both their presentation and goals.

Treatment

There is no ‘one-size-fits-all’ for chronic pain.  Our physiotherapists will clear up misinformation or confusing advice you may have received and work with you to develop an effective exercise and activity regime.  Frequently with chronic pain patients, hands-on administrations are not as successful as they may be in acute pain.  More commonly, an appropriate active regime can help you to reduce pain, improve flexibility and strength and regain your confidence to move.

Research shows that education and treatment which empowers you is a huge and effective part of chronic pain management.  

Reference: APA, Physiotherapy and Chronic Pain Fact Sheet v3.

To book an appointment with our physiotherapists Kathryn Barry or Michael Dessen, please call 9634 7788.