Chronic pain: How physiotherapy can help you

Imagine waking up every morning with a throbbing, stabbing pain that stays with you all day long. A pain that digs into your bones and holds you captive like invisible shackles. This scenario may sound like a gruesome idea to some people, but for millions of people around the world, it is reality.

Chronic pain is a complex and common problem that can significantly impact your life. Unlike acute pain, which usually occurs as a warning sign of injury or illness and subsides over time, chronic pain is persistent and can last for months or even years.

How can physiotherapy help here? What treatment approaches are used and what do case studies say? Read on to find out.

• What is chronic pain?
• Can physical therapy treat chronic pain?
• Which techniques are suitable?
• What do studies say?

1. What is chronic pain?

The impact of chronic pain on your quality of life is enormous. Everyday activities that other people take for granted can become insurmountable challenges for you. These include standing in line, lifting shopping bags or playing with your children. In addition, chronic pain can also lead to sleep disturbances, mood swings, anxiety and social isolation.

Unlike acute pain, which is caused by a specific injury or inflammation and usually heals, chronic pain is long-lasting and often difficult to localize. It can manifest as a dull, continuous ache or as intermittent, sharp stabbing pains. Chronic pain can affect different areas of your body, such as your back, neck, joints or muscles.

What is behind it?

One possible explanation is the concept of "pain sensitivity" or "central sensitization". This involves an increased reaction of the nervous system to pain stimuli, which means that even normal stimuli can be perceived as painful.

In chronic pain, it is thought that pain signals in the central nervous system are amplified and altered. This means that pain stimuli are perceived more intensely and are overly sustained, even when the original injury or inflammation has already subsided. These changes may be due to neuroplastic processes in the brain, in which there is a change in neural connections and circuits.

Possible causes may be:

• Injuries: acute injuries that do not heal properly, e.g. back injuries, herniated discs, pinched nerve
• Inflammation: Inflammation such as that seen in conditions such as arthritis, fibromyalgia or inflammatory bowel disease; the persistent inflammatory response can irritate nerve endings and cause pain
• Nerve damage e.g. diabetic neuropathy, nerve injuries or complications after surgery
• Muscle tension and injuries: this can be caused by poor posture, overload or stress
• Psychological factors , e.g. stress, anxiety, depression and traumatic experiences

As a non-pharmacological approach to pain relief, physical therapy has gained prominence and offers a promising way to manage symptoms and lead a more active life.

2. Can physical therapy treat chronic pain?

The answer is clear: yes, physical therapy can play an important role in relieving chronic pain. Chronic pain is often a complex issue that affects various aspects of the body and mind. Physical therapy offers a holistic approach to treating chronic pain by focusing not only on pain relief but also on improving the patient's functionality and quality of life.

Non-medicinal

A key benefit of physical therapy in treating chronic pain is that it offers a non-drug approach. This is particularly beneficial for patients who either want to avoid side effects of pain medications or for whom traditional drug therapies have not been sufficiently effective. Physical therapy aims to address the underlying causes of pain and strengthen the body through targeted exercises, manual techniques and physical therapies.

Through targeted movement and exercise programs, physiotherapy can help improve mobility, strength and endurance. This in turn can lead to a reduction in pain and improve functionality in everyday life. In addition, physiotherapy can also help to relieve muscular tension, which is often associated with chronic pain.

Understanding your body

Another important aspect of physical therapy treatment for chronic pain is patient education. Physical therapists can help you develop a better understanding of your pain by explaining how it arises and how it affects your body. This knowledge can help you better manage your pain and use targeted self-help measures to reduce your symptoms.

However, it is important to note that physical therapy is usually used as part of a comprehensive treatment plan when treating chronic pain. Depending on the individual situation, other therapeutic measures such as medication, psychological support or alternative therapies may be necessary. A multidisciplinary approach, in which different professionals work together, can often be the best strategy to effectively manage chronic pain.

3. Which techniques are suitable?

To treat chronic pain, physical therapists have various techniques and treatment approaches at their disposal. Here are some common concepts that can be used in physical therapy treatment of chronic pain:

1. Manual therapy: This approach includes various manual techniques such as mobilizations, manipulations and stretches to improve joint mobility and relieve muscular tension. Manual therapy can be particularly effective for pain in the spine, neck or joints.
2. Strengthening and stabilization exercises: Targeted exercises to strengthen muscles and improve stability can help improve the body's functionality and reduce pain. This can be achieved through strengthening exercises, balance training, or specific exercises for the affected area.
3. Posture and ergonomic adjustments: Improving posture and making ergonomic adjustments can help reduce unnecessary stress and strain on the body. Physical therapists can help you learn proper posture and make adjustments at work, in daily life, or during sports to minimize pain.
4. Relaxation techniques: Relaxation techniques such as progressive muscle relaxation, breathing exercises or yoga can help to relieve muscular tension and reduce stress. By reducing stress and tension, chronic pain can often be alleviated.
5. Electrotherapy and thermal applications: The use of electrotherapy, such as TENS (Transcutaneous Electrical Nerve Stimulation), or thermal applications, such as heat or cold therapy, can help relieve pain and promote blood circulation and muscle relaxation.
6. Patient education and self-management: An important aspect of physical therapy treatment for chronic pain is patient education. Physical therapists can help you develop a better understanding of your pain and provide you with tools and strategies for self-management of your pain. This can make it easier to manage pain in everyday life and improve control of your symptoms.

It is important to stress that the choice of appropriate techniques and approaches should be individualized. An experienced physiotherapist will conduct a thorough assessment of your situation to develop a customized treatment that meets your specific needs.

4. What do studies say?

Chronic pain is a widespread problem that affects many people around the world. According to the 2017 Global Burden of Disease Study, an estimated 20% of adults worldwide suffer from chronic pain.

The effectiveness of physiotherapy in treating chronic pain has been studied in numerous studies. A meta-analysis published in the British Journal of Sports Medicine analyzed a large number of research papers and concluded that physiotherapy is an effective method for reducing pain and improving functionality in various types of chronic pain. This study demonstrated the positive effects of physiotherapy on back pain, neck pain and osteoarthritis.

In addition to the scientific studies, there are also numerous testimonials from patients who have benefited from physiotherapy in the treatment of their chronic pain. Many patients report significant pain relief, improved mobility and an increased quality of life after physiotherapy treatment. This can help them to better manage their daily activities and feel better overall.

A holistic approach to treating chronic pain can often achieve the best results. Physiotherapy can be combined with other forms of therapy such as medication, psychological support and alternative therapies in a multidisciplinary approach. This allows for individually tailored and comprehensive care to achieve the best results for the patient.