While most patients don’t immediately think of physical therapy as a possible solution to chronic pain, PTs are actually well equipped to help address and alleviate chronic pain symptoms.
Chronic pain is defined as an uncomfortable, unpleasant physical feeling or sensation lasting for more than three months—or longer than a normal, reasonable healing time. In chronic pain cases, there is no actual injury or damage to any body structures. Instead, the pain centers in the brain are triggering these sensations even though there is no real threat.
Chronic pain affects different people in different ways. It is very personal, which means that compared to other types of pain, it can be more difficult to understand and address. Many patients have trouble pinpointing the pain and/or its causes, and they may describe the condition as “hurting everywhere.” Some report a connection between emotional wellbeing and pain severity (i.e., it hurts worse when the patient is feeling sad, anxious, or stressed).
Those suffering from chronic pain may also suffer from:
- Fear/avoidance of any physical activity
- Increased reliance on family members to assist with daily functions
- Stiffness throughout the body
- Muscle weakness and atrophy (i.e., deconditioning)
- Poor circulation
- Weight gain (which can cause or aggravate other conditions like high blood pressure and diabetes)
- Increased use of painkillers
- Depression and anxiety
- Avoidance of social situations
- Poor job performance
While most patients don’t immediately think of physical therapy as a possible solution to chronic pain, PTs are actually well equipped to help address and alleviate chronic pain symptoms. To begin, the therapist will perform an initial evaluation to:
- Understand past and present symptoms and treatments;
- Assess how the pain is impacting daily the patient’s daily life;
- Identify any problems with posture, flexibility, muscle and joint function, and general movement (the therapist will use a variety of tests and measures to do this); and
- Determine whether the patient would benefit from developing alternative movement patterns or using assistive devices.
If the therapist suspects that an underlying medical condition may be contributing to the pain, he or she may refer the patient to another medical provider or recommend imaging tests (e.g., x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI)).
After completing the initial evaluation, the therapist will work with the patient to develop a treatment plan and corresponding goals. Treatment may include:
- Education on pain management and how a patient’s lifestyle may influence pain symptoms;
- Exercises to improve strength and flexibility, thus reducing stress on the body and improving coordination and movement patterns;
- Hands-on techniques like joint and muscle mobilization and manipulation; and
- Training in proper body mechanics and posture awareness.
While specific individual goals will vary, generally speaking, the therapist will try to help the patient maintain a normal lifestyle as much as possible. This includes helping the patient avoid bedrest, as prolonged rest periods often worsen the symptoms associated with chronic pain.
All physical therapists have the skills and training necessary to treat a variety of neuromusculoskeletal conditions. However, if you are suffering from chronic pain—and you are interested in pursuing physical therapy as a treatment option—you may benefit from seeking out a therapist who has experience working with chronic pain patients.