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.
This is often a result of central sensitisation, a process by which the central nervous system (brain and spinal cord) becomes hypersensitive to stimuli, leading to an increased perception of pain. It occurs when there is a persistent or repeated input of pain signals that leads to changes in the structure and function of the central nervous system.
Central sensitisation can occur in various conditions, including chronic pain syndromes such as fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome, as well as in response to injury or surgery. It is often associated with changes in the brain’s processing of pain signals and can also cause other symptoms such as fatigue, sleep disturbances and mood changes.
The treatment of chronic pain is challenging and typically involves a multidisciplinary approach, including physiotherapy, medication and cognitive-behavioural therapy.
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.
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