What is Chronic Pain Physical Therapy?
Chronic pain is defined as pain that lasts over 3 months. It is an epidemic in the United States with more than 50 million people suffering, costing America an estimated 600 billion dollars annually in lost wages and medical costs. Sales of prescribed opioids have also quadrupled in response, although the impact it has had on the chronic pain epidemic is minimal and even harmful with rising rates of opioid addiction. And while opioids do have their place in healthcare, it is now widely accepted that non opioid approaches including physical therapy should be utilized for chronic pain rehab instead.
Chronic pain can present in many forms such as dull aches, stabbing pains, burning, and sharpness. Recent advances in modern pain science have totally revolutionized the way we think about chronic pain. The International Association for the Study of Pain now defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The definition points to pain being a product of the brain in that your brain produces the sensation in response to what it perceives as a threat. Normally, this would only be in response to actual tissue damage such as a burn or sprained ankle. This pain mechanism however can go haywire, resulting in persistent pain that extends well beyond what it should, even if a tissue has healed already. It is important to acknowledge when there is chronic pain in the absence of tissue damage, the pain experience is 100% real and can be just as distressing as normal pain responses to harmful stimuli. These developments are a paradigm shift in how we think about pain and has resulted in more effective treatments within the realm of physical therapy.
How Does Physical Therapy Help with Chronic Pain?
Physical therapy has a proven track record when it comes to managing chronic pain. Treatment often entails pain education, manual therapy, therapeutic exercise, relaxation techniques and counseling. While physical therapy is not a cure-all, it is immensely helpful in helping people move more efficiently and return to prior activities.
Graded exposure and graded exercise are now a cornerstone of chronic pain rehabilitation. These approaches focus on gradually reintroducing movement and activity in a way that is manageable and non-threatening to the nervous system. By starting with tolerable activities and progressively increasing intensity or duration, physical therapy helps patients rebuild strength, reduce fear of movement, and retrain their bodies to tolerate physical activity. This method is highly individualized, ensuring that each person’s unique pain levels, goals, and abilities are respected while fostering long-term improvements in function and quality of life.
As a chronic pain sufferer myself, I am uniquely positioned to assist those living with chronic pain. You can learn more about my chronic pain journey by clicking here.
Common Symptoms of Chronic Pain
- Anxiety
- Depression
- Body Stiffness
- Fear of Movement
- Deconditioning
- Increased Use of Medications
- Unwanted Weight Gain
- Sensory Sensitivity
- Migraines
- Low Back Pain
- Muscle Pain
- Pain in Multiple Body Parts
- Sleep Issues
- Fatigue
Common Chronic Pain Disorders
Chronic Pain comes in many different forms with a wide array of presentations. You will find some common chronic pain disorders listed below as well as how physical therapy can help.
Chronic back pain is the leading cause of disability in the world. Although rarely dangerous, chronic low back pain can greatly reduce one’s quality of life. Physical therapy intervention consists of pain science education, manual therapy, and therapeutic exercise.
Migraines are actually the second leading cause of disability in the world. Far more than a headache, migraine is a neurological disorder that comes with a whole host of symptoms such as light sensitivity, sound sensitivity, dizziness, and facial pain.
To learn more about physical therapy management of migraine and headaches, please click here to be directed to our dedicated page on migraine treatment.
Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It often includes additional symptoms such as sleep disturbances, brain fog, and heightened sensitivity to pain. While the exact cause of fibromyalgia is not fully understood, it is believed to involve abnormal pain processing in the central nervous system.
Physical therapy intervention involves a mix of manual therapy, therapeutic exercise, conditioning and gradual exposure to physical activity.
Chronic neck pain often involves symptoms of stiffness, decreased range of motion, and muscular tension. It is very common although that doesn’t make it any less distressing. It is often an accompanying symptom of other chronic pain disorders such as fibromyalgia.
To learn more about physical therapy intervention for chronic neck pain, please click here to be directed to our dedicated page on neck pain treatment.
Chronic Fatigue Syndrome, also known as Myalgic Encephalomyelitis (ME/CFS), is a complex and debilitating condition characterized by profound fatigue that is not alleviated by rest and worsens with physical or mental activity. Other symptoms may include brain fog, sleep disturbances, muscle and joint pain, sore throat, headaches, and sensitivity to light, noise, or touch. The exact cause of ME/CFS is unknown.
Physical therapy intervention is aimed towards graded pacing of activity, pain management, energy conservation techniques, and therapeutic exercise.
Complex Regional Pain Syndrome (CRPS) is a chronic pain condition characterized by severe pain and inflammation. It is typically only in one limb although it can be more widespread. Symptoms include burning pain, skin changes, and swelling. The exact cause is unknown but is thought to be arise from an abnormal nervous system.
Physical Therapy intervention consists of desensitization techniques, graded exercise, manual therapy, and pain science education.
Ehlers-Danlos Syndrome (EDS) and Postural Orthostatic Tachycardia Syndrome (POTS) are conditions that can contribute to dizziness, headaches, fatigue, and chronic pain. Because they affect the body’s connective tissue and autonomic regulation, symptoms often overlap with migraine and vestibular disorders. Our physical therapy approach can be tailored to address these underlying factors through gentle movement retraining, pacing, and autonomic conditioning.
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References:
- Effectiveness of Cognitive Functional Therapy Versus Core Exercises and Manual Therapy in Patients With Chronic Low Back Pain After Spinal Surgery: Randomized Controlled Trial
- Low-Intensity Physical Exercise Improves Pain Catastrophizing and Other Psychological and Physical Aspects in Women with Fibromyalgia: A Randomized Controlled Trial
- Pain: The Silent Public Health Epidemic
Frequently Asked Questions
What is Vestibular Rehab Therapy, and how can it help me as an athlete?
Vestibular rehab therapy focuses on training your balance system (inner ear, eyes, and brain) to improve coordination and prevent injury. For athletes, this can translate to better performance in terms of balance, reaction times, and hand-eye coordination, all of which are vital for excelling in sports.
Who should consider vestibular rehabilitation therapy?
Athletes in contact sports like football, boxing, and MMA are ideal candidates, but any sport that demands sharp coordination and balance can benefit from vestibular rehabilitation therapy. Even if you’re not currently experiencing issues like dizziness, prehab can help prevent them.
How does a certified vestibular rehab therapist differ from other therapists?
A certified vestibular rehab therapist has specialized training to evaluate and treat balance-related disorders and dizziness. They are equipped with the expertise necessary to help athletes strengthen their vestibular systems and prevent injuries, offering personalized care based on each athlete’s specific needs.
Can vestibular physical therapy prevent concussions?
While vestibular physical therapy cannot fully prevent concussions, it can reduce the likelihood of vestibular disruptions caused by concussive injuries. This kind of therapy focuses on improving balance and coordination, which can lessen the severity of balance-related issues post-injury and help athletes recover more quickly.
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