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Physical Therapy for Chronic Pain

People often seek physical therapy for pain. Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.”

When we think of pain, we often think of acute pain. Acute pain is short in duration, usually lasting up to 12 weeks. Acute pain is your body’s way of protecting you from further injury. For example, if you sprain your ankle playing soccer, the body sends a “danger” signal to your brain which results in the sensation of pain, preventing you from continuing to run. This is a good thing – it is a warning signal that the “threat” of tissue damage has occurred or may occur, and is sometimes a message to seek medical attention.

Contrary to popular belief, pain is not always indicative of tissue damage. This is often the case with chronic pain. Chronic pain is an unpleasant experience lasting greater than three months, or longer than expected tissue healing times. Chronic pain results from physiological changes in the brain and nervous system that lower the threshold for the “danger” signals to be activated. This means that the nervous system sends warning signals (i.e. pain) in the absence of a continued threat of injury or tissue damage.

Symptoms of Chronic Pain:

  • Vague, widespread pain that may move from one area to another
  • Symptoms that worsen without doing anything to increase the pain
  • Sharp/shooting pain without a consistent pattern
  • Feelings of excessive fatigue, frustration, anxiety, depression or fear of performing normal daily activities

How can Physical Therapy help with Chronic Pain?
Physical therapists work as part of a multidisciplinary team of healthcare professionals to diagnose and treat chronic pain.

  • During an initial evaluation, physical therapists conduct a thorough examination to:
  • Gain an understanding of the history and development of your pain
  • Obtain a clear picture of your specific pain such as the type, intensity, how and when it occurs
  • Perform movement and specialized diagnostic tests to identify contributing factors and rule out any potential serious health conditions

Physical therapy treatments include:

  • Pain Science Education on how chronic pain works, what the sensation of pain does and doesn’t mean and what you can do to manage your specific symptoms.
  • Graded exposure to movement to help you gradually improve your tolerance for movement, your ability to perform your daily activities with less discomfort and your quality of life. Graded movement guided by your physical therapist is carefully designed to decrease the sensation of pain.
  • Manual therapy consists of hands-on techniques that can reduce pain and improve movement of the joints and muscles.

Working with a qualified physical therapist can help you manage your pain, improve your quality of life and get back to doing the things you love.

Arribas-Romano, A., Fernández-Carnero, J., Molina-Rueda, F., Angulo-Diaz-Parreno, S., & Navarro-Santana, M. J. (2020). Efficacy of physical therapy on nociceptive pain processing alterations in patients with chronic musculoskeletal pain: a systematic review and meta-analysis. Pain Medicine, 21(10), 2502-2517.
Louw, A., Diener, I., Butler, D. S., & Puentedura, E. J. (2011). The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Archives of Physical Medicine and Rehabilitation, 92(12), 2041-2056.
Louw, A., Zimney, K., Puentedura, E. J., & Diener, I. (2016). The efficacy of pain neuroscience education on musculoskeletal pain: a systematic review of the literature. Physiotherapy theory and practice, 32(5), 332-355.
Raja SN, Carr DB, Cohen M, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-1982. doi:10.1097/j.pain.0000000000001939
Zane, M. (2016, June 15). Physical Therapy Guide to Chronic Pain. Choose PT. Retrieved February 20, 2023, from https://www.choosept.com/guide/physical-therapy-guide-chronic-pain

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