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Chronic Pain Physiotherapy

Chronic pain refers to a pain that doesn't (seem) to go away, and has lasted for at least three (3) months since it happened. Example is someone who injured their back, resulting in back pain, and even after 3 month, they are still experiencing back pain - that's termed as chronic back pain.

There are different schools of thought of how to define pain and its length of time before it can be classified as "chronic", but to make things simple, we classify it simply as pain that has lasted beyond 3 months of when it first started (which confirms that the duration has gone beyond the usual healing time required)

types of chronic pain

There are two (2) general types of chronic long term pain:

1. Nociceptive Pain - pain experienced that is caused by activation of nociceptors in our body
   
   
2. Neuropathic Pain - pain experienced that are caused by damage or abnormal functioning of our nervous and/or neurological system
   

pain's effect on tasks and activities

Research papers are showing that long term pain does impact, influence and affects the patient's brain functions. Patients often have common mental challenges, indicating of:

• difficulty paying/sustaining attention
  
• difficulty remembering details/information
  
• difficulty completing tasks/activities

This may be due to ongoing pain that distracts their attention, which in turn decreases their ability to focus and participate in any activities or work in the scope that they'd like to be in (eg back pain, or fear or recurring back pain, causing decrease participation in activities and exercises).

chronic pain management with physiotherapy

Pain is very subjective and diverse, and different patients will have different responses to pain, depending on their:

• age
• race
• gender
• culture
• expectation/hope
• life experience
• etc

Physiotherapy: will focus primarily on physical aspects of the patient, especially when it comes to improving strength, stamina, stability and removing pain as much as possible. Eg for a patient with back pain, the physio will first focus on pain relief, then provide customized physiotherapy exercises to treat the core cause of the back pain in the first place.

Occupational / Hand Therapy: if it's hand injury resulting in requiring hand therapy, the approach is similar to physiotherapy goals as above. However, occupational therapists often focus on the mental and activity management, eg in the case of patient with back pain, the occupational therapist will focus on

• pain management be it by visualization, rationalization, regulated deep breathing
• activity management eg making tasks easier, incorporating pain management techniques
• normalization of activities of daily living eg dressing, showering, toileting, cooking, etc
  
• etc

Patients may benefit from ongoing deep tissue massage therapy and acupuncture therapy, as both of these therapies provide a long-term solution, which is able to "layer benefits" eg if 2 patients had the exact same

• conditions
• age
• gender
• work
• responsibilities

but one of them decides for ongoing regular deep tissue therapy and acupuncture therapy, as compared to the other who doesn't, the one who goes for regular treatment will generally recover and heal faster from injuries, is more resilient, less pai experience etc (applies to patients with chronic pain as well).

do not live with pain

Pain is uncomfortable and can cause anxiety, fear and even depression, be it short term or long term pain. Patients may even report

• difficulties sleeping (hard to fall asleep, waking up frequently, hard to go back to sleep)
• difficulties coping (increased catastrophizing, over-worry - will benefit from craniosacral therapy for chronic pain)
• chronic headaches

Some patients may turn to/compensate with excessive sleeping, eating, substance abuse etc - please get in touch with us and we will help walk with you through this painful time. We will also help refer you to professionals that we know can help you.