Chronic pain is a persistent or recurring pain that lasts for an extended period, typically lasting for at least three to six months or more. Unlike acute pain, which is a normal sensation triggered by the nervous system as a response to injury or tissue damage, chronic pain persists even after the injury or underlying cause has healed.
When pain continues for months beyond normal healing time, it becomes chronic — and the longer it lasts, the less it tends to respond to conventional treatments like medication, surgery, or manual therapy.
This is often because of changes within the central nervous system — a process known as central sensitisation. Here, the brain and spinal cord become hypersensitive to signals, amplifying the experience of pain, even in the absence of ongoing tissue damage. This heightened sensitivity can develop after injury, surgery, or illness, and is also common in chronic pain conditions like fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome.
Central sensitisation doesn’t just affect pain — it can also lead to symptoms like fatigue, sleep disturbances, and mood changes. This shift in how the body processes pain is known as nociplastic pain — and it is potentially reversible.
Research shows that nociplastic pain responds best to self-management and lifestyle-oriented strategies. These include implementing regular physical activity, pacing and energy management, mind-body practices (e.g., relaxation, mindfulness, breathing techniques)and cognitive and behavioural strategies. These approaches help to “retrain” the nervous system, reduce sensitivity, and restore balance.
The International Association for the Study of Pain (IASP), the global leader in pain science, states:
“Self-management is the first rung of the ladder in pain care — followed by primary care, with specialty care and pain centres most appropriately used for the most complex problems.” In other words, self-management is not just the starting point — it is the foundation of long-term pain care.
The good news is that you don’t have to do it alone; Riley Physiotherapists are here to guide and support you along the journey.
Physiotherapists involved in the treatment of chronic pain use a psychologically-informed rehabilitation approach. This may include educating patients about the latest pain neuroscience, manual therapy, graded exposure to physical activity in a safe manner, specific targeted exercises, relaxation, self-management techniques and advice about basic nutrition, sleep hygiene and lifestyle changes The goal is to reduce pain levels and improve physical function, despite pain, and assist the person in doing the things that mean something to them, to “get their life back".
Physiotherapy can help reduce pain levels through various techniques such as exercise therapy, manual therapy, relaxation techniques, self-management techniques and lifestyle changes.
Chronic pain can lead to reduced physical function, such as limited mobility and difficulty carrying out daily activities. Physiotherapy can help improve physical function by safely implementing activity programs and strengthening muscles, improving range of motion, and enhancing balance and coordination.
Physiotherapy can help individuals reduce their dependence on pain medications by providing alternative pain management strategies.
Chronic pain can impact an individual’s emotional well-being, social interaction and overall quality of life. Physiotherapy can help improve emotional well-being, restore social connections, and enhance overall quality of life.
Physiotherapists can empower patients with understanding of their condition and appropriate self-management strategies, so that they are able to make their own decisions, manage their own condition and lead fulfilling lives.
Physiotherapy for chronic pain should be considered as soon as possible. Chronic pain can lead to significant physical and emotional impairments, and early intervention can help prevent further deterioration of these conditions.
Chronic pain can impact an individual’s ability to carry out daily activities such as work, household chores, or leisure activities. Physiotherapy can help individuals improve their physical function and reduce their dependence on medications.
Chronic pain can lead to depression, anxiety, and other mental health issues. Physiotherapy can help individuals learn coping strategies to manage their pain and improve their emotional well-being.
Chronic pain can disrupt sleep patterns, leading to fatigue and further physical and emotional impairment. Rehabilitation can help individuals improve their sleep quality, which can, in turn, reduce pain levels.
Chronic pain can impact an individual’s ability to enjoy life fully. Physiotherapy can help individuals improve their physical function, emotional well-being and overall quality of life.
Juli-Ann Riley, together with Occupational Therapy colleague Helen Roome, offer multidisciplinary group pain self-management programmes for private persons, insurers and corporates.
