Physiotherapy is a physical therapy that revolves around movement and strengthening the body. It is a highly effective way to help people with chronic pain manage their condition and return to normal life activities.
Physiotherapists use soft tissue treatments, massage, myofascial release and stretching to decrease pain and desensitise areas of the body. They also advise patients on posture, nutrition and exercise.
Exercises
Most physiotherapy treatments include a number of exercises that will help reduce pain and improve movement. These can be passive (the therapist moves the body part) or active-assisted (you carry out the movements with help).
Your physiotherapist will provide you with an exercise plan that you will need to follow at home. It is important to commit to this, and be consistent with it! The most effective way to stick with an exercise program is to think of it as something you do every day, and treat it as seriously as brushing your teeth. Stick post-it notes to your bathroom mirror, the fridge or other places where you can see them throughout the day, to serve as reminders of your exercises.
The goal of physiotherapy is to give you the tools and confidence to manage your pain. This will enable you to resume activities and lead a normal life, again. It can be a difficult transition to get used to the idea of doing daily physical activity with pain, but your physiotherapist will teach you to pace yourself, and avoid the boom/bust pattern of activity and pain. Hervey Bay’s trusted physiotherapy clinic has developed the best exercises to help their clients return to a relatively pain-free life.
There are many types of physiotherapy exercises, including stretching, range of motion and strength training. They may be active or passive, and can be done by you alone, with a helper, or with the therapist doing them for you.
In addition to strengthening, there are also cardiovascular and balance/disorders of gait/coordination exercises. These can be very beneficial to people with chronic pain, as they increase the overall fitness level and reduce pain in the injured areas.
Another important element of physiotherapy is the use of heat and cold treatment, which can desensitise the area and block pain signals to the brain. This can be a useful tool in managing the heightened fear and anxiety that often accompanies chronic pain. A physiotherapist will be able to advise you on what heat/cold treatment options are most appropriate for your specific condition. You may also be provided with an exercise mat, foam rollers and other equipment to assist you in your recovery at home.
Manual Therapy
Manual therapy is an important part of physiotherapy treatment for chronic pain, especially when it’s combined with other treatments. It can include soft tissue work (including massage), which helps to relax muscles, increase circulation and break up scar tissue; mobilization/manipulation, which involves using measured movements of varying speed, force and distance (called ‘amplitude’) to twist, pull or push bones and joints into position in order to decrease stiffness, reduce pain in surrounding tissues and help with flexibility and alignment.
A physical therapist will assess your symptoms, history and physical examination to decide whether you are a candidate for manual therapy. You will need to discuss your pain and what makes it better or worse. Your therapist may also suggest other treatments, such as cognitive behavioural therapy, which can be very effective for people who suffer from chronic pain. This involves teaching patients to replace negative thoughts and behaviours with positive ones, which can help them to manage their pain effectively.
Your therapist will develop a treatment plan to address your specific needs and goals. This will often include exercises, such as stretches and strength training. Exercise is a powerful tool for treating pain, as it teaches your body to move with less stress and strengthens muscles, which can reduce the amount of pain you feel.
Physiotherapists will also use education and movement retraining to improve posture, movement patterns and muscle imbalances. This can help to reduce the pain you experience and prevent it from recurring in the future.
In addition, your therapist might recommend soft tissue treatments, such as massage, trigger point therapy and myofascial release to help relax muscles, increase circulation and break up scar tissues. These treatments can be particularly useful in reducing pain and improving movement by desensitising the area of pain. This can then allow for more targeted movements, such as Pilates or postural exercise. Moreover, this can help to improve balance and reduce the risk of falls.
Education
When we experience pain it is a natural part of the body’s healing process, but sometimes this can become chronic and cause further damage to a person’s physical and mental health. When this happens it becomes a medical condition known as chronic pain syndrome. Physiotherapy, also known as physical therapy, is an extremely important treatment for this type of condition. It can help to improve an individual’s mobility, increase strength and reduce pain levels. There are a wide range of techniques and exercises that physiotherapists use to treat and manage chronic pain.
One of the most important is education and improving a patient’s understanding of their condition. This helps them to challenge their fears that every pain means further injury or harm, which can lead to maladaptive (unhelpful) behaviours like sleeping badly, not eating regularly and withdrawing from social activities. These behaviours can make a person’s pain worse, increase their emotional distress and decrease their ability to function as well as making it harder for them to cope with their symptoms.
The therapist will teach them that they can change the way their body responds to pain, by using techniques such as progressive neural reeducation (PNE). This involves slowly increasing the difficulty of an exercise, which teaches the brain that pain is no longer a threat and changes the feedback that is sent to the brain, which will reduce the person’s perception of the discomfort as time goes on.
Manual therapy is another very important aspect of physiotherapy for people with chronic pain. This includes soft tissue treatments, such as massage, trigger point therapy and myofascial release and a variety of joint mobilisation techniques. It can help to reduce muscle tightness, improve joint mobility and decrease pain levels.
Other physiotherapy techniques for managing chronic pain include teaching postural awareness and body mechanics, a graded approach to increasing exercise and activity, behavioural therapy such as graded motor imagery and cognitive behavioural therapy, the development of a range of self management strategies and goal setting. These techniques can be used as stand alone treatments or combined to form a multi-faceted approach to treating chronic pain.
Cognitive Behavioural Therapy
A significant aspect of pain management is changing how you think about your pain. Pain can be a scary thing to deal with. It is not always easy to understand why it hurts and it can feel like there is no way to manage it. This is where cognitive behaviour therapy can be very useful.
This is a short term form of therapy that involves changing the ways you think and act to help you deal with your pain. It can be provided in group or individual sessions and typically lasts for 8-12 sessions. It has been shown to be one of the most effective methods of controlling pain and can be done in conjunction with physical therapy.
Physiotherapists can use a number of different cognitive behaviour therapy techniques to help you manage your pain. This can include teaching relaxation techniques, helping you learn to identify and challenge unhelpful thoughts about your pain and encouraging you to try new behaviours. Your physiotherapist can also provide education about the cause of your pain and help you develop coping strategies to deal with it.
The pain that you experience will vary from person to person and will be very specific to the area affected. Your brain will respond to the pain by increasing sensations in and around the painful area, this is called a hyperalgesic response. Pain sensations are triggered by sensory input such as touch, light, movement, sounds and emotions. When you become overwhelmed by pain it can lead to anxiety, depression and a feeling of helplessness. This is where cognitive behavioural therapy can be helpful to reduce stress and improve mood.
In operant behavioural therapy the clinician will look at removing external factors that can negatively reinforce pain behaviours, these can include detrimental attention from family, medical staff, excessive rest and dependency on pain medication. The therapist will assist the client in developing a plan to remove these factors and introduce more healthy behaviours. This is often achieved by reintroducing the client to activity over time by identifying how long they can do an activity before their pain flares up and then resting. For example, they may start by mowing the lawn for 10 minutes and then resting for 5 minutes and doing this until the level of pain is too much to continue.
