Chronic pain can affect nearly every part of daily life, from sleep and mobility to work, exercise, and emotional well being. Unlike short term pain that often improves as an injury heals, chronic pain can persist for months or longer and may require a comprehensive approach. Physical therapy can play an important role by helping people improve movement, build physical capacity, and develop practical strategies for managing pain over time.
What is Chronic Pain?
Chronic pain is generally defined as having pain for more than 3 months. It is common to associate long term pain with conditions such as arthritis, back and neck pain that has become persistent, nerve problems, fibromyalgia and old injuries.
Pain from chronic conditions is not all made up of tissue damage. Other factors such as weakness, reduced mobility, abnormal movement, stress, sleep problems and a fear of movement all play a big part in the individual’s experience of pain.
Thus, management of pain with the aim to improve function in general is more successful than trying to make pain disappear completely. As for chronic back pain, fibromyalgia as well as hip and/or knee osteoarthritis, there is evidence for the success of exercise therapy.
How Physical Therapy Helps Manage Chronic Pain
A major advantage of physical therapy is that treatment can be tailored to the individual’s condition, physical abilities, symptoms, and goals. Rather than applying the same exercises to everyone, a therapist can assess movement, strength, flexibility, balance, posture, and functional limitations before developing an appropriate program.
Treatment may involve several complementary techniques.
Therapeutic Exercise
A comprehensive exercise program for people with chronic pain can include a range of exercises to include stretching, strengthening, aerobic exercise, balance training, and increased mobility through improved movement and range of motion.
Strengthening weak muscles helps patients with chronic pain to regain their physical capacity. Mobility exercises can in turn increase patients’ range of motion. Slowly but surely increasing patients’ endurance for aerobic activities is also an important objective.
Also of paramount importance is the rate of completion of an exercise program for individuals with chronic pain. Even small increases in activity completed on a regular basis by individuals with chronic pain can enable improved physical capacity for daily activities. It is also important to ensure that programs are completed on a regular basis and that individuals are able to manage pain between sessions.
Improving Movement and Function
Movement can often be adapted to manage pain. As part of the program, a patient’s limited movement will be identified and strategies will be provided to help complete activities of daily living in the best way possible and complete exercises comfortably.
Patients learn to perform activities safely and efficiently. Activities include walking, lifting, sitting, reaching for objects, and completing exercise. Recreational activities can also be addressed.
Manual Therapy
Depending on the diagnosis and individual circumstances, treatment may also include hands-on techniques designed to address mobility restrictions and discomfort. Manual therapy can sometimes be combined with therapeutic exercise to help patients move more comfortably. However, hands on treatment is generally most useful when it supports broader rehabilitation goals rather than serving as the only component of care.
Education and Self Management
With a good education about your condition and your activities the patient can manage their own recovery. They can learn how much activity they need and how to increase this in an appropriate way for exercises.
It’s also important for patients to learn about their condition and to understand the impact that their activities can have on their symptoms. Educating patients on issues relating to activity, exercise, and symptoms can help to take uncertainty out of the movements and activities that patients perform on a daily basis and allow patients to manage their symptoms on an on-going basis.
Physical Therapy and an Active Approach to Pain
It is so important for people living with persistent pain to continue appropriate physical activity in order to increase strength and enhance physical capacity.
This would apply in particular for someone with chronic pain but can be modified for use by people generally to determine their optimal level of activity.
When to Consider Physical Therapy
If you suffer from persistent pain, are unable to move, are weak, or are having problems with activities needed for daily living, it is time to consider physical therapy or rehabilitation. Speak with your doctor to find the best qualified health care professional for you.
Note: New, severe, unexplained, or worsening symptoms must receive an appropriate medical evaluation, rather than assuming they are a musculoskeletal problem.
Endnote
Through individualized exercise, movement education, functional training, and other appropriate techniques, rehabilitation can help people gradually improve their physical abilities and become more confident in managing persistent pain.
When combined with appropriate medical care and healthy lifestyle habits, physical therapy can be an important part of a comprehensive long term pain management strategy.
Written by Boris Petrov (outreach@dzhingarov.com)
