Physical Therapist’s Guide to Chronic Pain Syndromes

Chronic pain is a condition that occurs when the brain concludes there is a threat to a person’s well-being based on the many signals it receives from the body. This condition can and often does occur independently of any actual body tissue damage (due to injury or illness), and beyond normal tissue healing time.
It is estimated that 116 million Americans have chronic pain each year. The cost in the United States is $560–$635 billion annually for medical treatment, lost work time, and lost wages.
The causes of chronic pain vary widely. While any condition can lead to chronic pain, there are certain medical conditions more likely to cause chronic pain. These include:

  • Trauma/injury
  • Diabetes Mellitus
  • Fibromyalgia
  • Limb amputation
  • Reflex Sympathetic Dystrophy

Some diseases, such as cancer and arthritis, cause ongoing pain. With chronic pain, however, pain is created in the nervous system even after physical tissues have healed.
Chronic pain affects each person experiencing it differently. In some cases, chronic pain can lead to decreased activity levels, job loss, or financial difficulties, as well as anxiety, depression, and disability. Physical therapists work together with chronic pain patients to lessen their pain, and restore their activity to the highest possible levels. With treatment, the negative effects of chronic pain can be reduced.

How Can a Physical Therapist Help?
Your physical therapist will work with you to educate you on chronic pain, find solutions to improve your quality of life, and get you moving again! He or she will help you improve movement, teach you pain management strategies, and, in many cases, reduce your pain.
Not all chronic pain is the same. Your therapist will evaluate your clinical examination and test results and design an individualized treatment plan that fits you best.
Physical therapy treatments may include:
Education to improve your knowledge and understanding of chronic pain — how it occurs, and what you can do about it. Your therapist will teach you how to manage your pain and help you work toward performing your normal daily activities again.
Strengthening and flexibility exercises to help you move more easily with less discomfort. Your therapist will design a program of graded exercises for you — movements that are gradually increased according to your abilities. Graded exercises help you improve your coordination and movement, reducing the stress and strain on your body, and decreasing your pain. Carefully introducing a graded exercise program will help train your brain to sense the problem area in your body without increasing its danger messages.
Manual therapy, which consists of specific, gentle, hands-on techniques that may be used to manipulate or mobilize tight joint structures and soft tissues. Manual therapy is used to increase movement (range of motion), improve the quality of the tissues, and reduce pain.
Posture awareness and body mechanics instruction to help improve your posture and movement. This training helps you use your body more efficiently while performing activities and even when you are resting. Your therapist will help you adjust your movement at work, or when performing chores or recreational activities, to reduce your pain and increase your ability to function.
The use of ice, heat, or electrical stimulation has not been found to be helpful with chronic pain. Your physical therapist, however, will determine if any of these treatments could benefit your unique condition.
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