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Physical Therapy For Chronic Pain

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Pain Relief Through Physical Therapy

Physical Therapy, CRPS, and Chronic Pain with Julie Bergmann, PT, OCS – RSDSA

Libby Mitchell

We think of physical therapy when we think of recovering from an injury or a surgery. Broken leg? Youll need physical therapy. Knee replacement? See you in PT. However, physical therapy can be effective in treating a condition more than 3 million Americans live with every day: chronic pain.

It is a much better option than pain killers in many circumstances, particularly with longstanding musculoskeletal conditions, says Tamara Dangerfield, MPT, a physical therapist with University of Utah Health. Movement-based therapies become more and more effective for pain control the more they are practiced, and the side effects include improved mood, blood pressure, weight control, bone density, endurance, strength, and sleep.

Pain relief through physical therapy is based in the knowledge that all forces in the body affect each other. When a nerve is pinched it can be due to compression from the muscle or fascia. Reducing that strain and restoring fluid movement will help alleviate the pain. It works similarly for other types of pain. Many people do not realize that the nerves and blood vessels that attach to all structures in the body, including organs as well as musculoskeletal structures, travel through muscle and fascia tissue, says Dangerfield. We work to restore the balance of coordination, flexibility, and strength so that movement, blood and nerve flow are not hindered.

What Causes Chronic Pain

Chronic pain can sometimes be difficult to treat, as it can be caused by many different factors and health conditions. If you have chronic pain in a specific area like your back, the pain may be coming from somewhere else in your body. The key to treating chronic pain is being able to identify the main source.

Common causes of chronic pain include:

Can You Do Physical Therapy At Home

Physical therapy has a lot of benefits for pain management, but no one wants to continue office visits forever. And thatâs a good thing: physical therapy is usually only short-term. With the right tools, it is possible to do some physical therapy at home to continue with your treatment. And, thanks to telehealth, you can continue to communicate with your therapist and update them on how youâre doing.

âMany of the stretches and strengthening exercises can be done at home on your own. In fact, any good physical therapy program should always include a structured home exercise program,â says Dr. Hascalovici. âI often have to remind patients that guided physical therapy isn’t something that should be prescribed indefinitely.â

And yes, you can go back to work during physical therapy if your healthcare provider and physical therapist agree. If your exercises are prescribed to address a work-related injury, such as carpal tunnel syndrome, you may be able to return to work while youâre still getting PT. If this is the case, itâs always a good idea to first discuss your treatment options with your primary care doctor.

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What Is Chronic Pain Syndrome

Chronic Pain Syndrome is severe discomfort in your body that lingers for months or years. While acute pain may last anywhere from hours to several weeks before your ailment heals, chronic pain doesnt go away. The intensity of your pain might subside, but itll ultimately return. Common chronic pain areas on the body are the back, knee, and neck. If youre experiencing any type of chronic pain, theres a solution for lasting relief.

Physical Therapy And Patient Education: The Perfect Combination

Physical Therapy For Chronic Lower Back Pain

Its important to keep in mind that every patients pain, body, and habits are different. That means physical therapy and pain relief varies from patient to patient. Physical therapists are trained to identify and monitor their patients pain so an effective treatment plan can be created and modified accordingly.

Studies show that kind of positive relationship between a physical therapist and their patient is incredibly important to their recovery and has a significant impact on the patients success. The more active a patient is in managing their pain, the better their physical therapist can work with your body and assess how you react to treatments.

When a physical therapist and patient have a positive relationship with open and honest communication about their care, the therapist can effectively educate the patient. This includes education about their specific pain and what is needed to treat the pain. Education increases understanding and patients who are equipped with knowledge about their pain and treatments are typically more active in their treatment process.

Physical therapy is more effective when patients understand why and how their exercises and treatment methods are helping their body heal and restore function. Patients will regain their ability to do what they love and improve their quality of life when following their physical therapy treatment plan and exercises.

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Exercise For Chronic Pain Management 7 Tips

Chronic pain leads many people to avoid physical activity. Pain medication is often relied on or prescribed to help manage pain. This can lead to other significant problems such as dependence. An alternative and effective pain management strategy has is regular exercise. Starting an exercise program, however, can be a whole other kind of pain.

If you believe the long-term health impact of exercise is the best option for you, here are tips for becoming more active.

Addressing Chronic Pain With Physical Therapy

Physical therapy and exercise can help you manage pain and stay active.

When living with pain from an injury, trauma or medical condition, being physically active and managing daily tasks can pose challenges. Regaining mobility, strength and flexibility can help you engage more easily with daily tasks. Physical activity through physical therapy can help reduce and manage chronic pain. Physical therapy is also a safe and effective choice to strengthen and improve a specific area of the body for long-term use, as well as minimize the need for pain management medications, such as prescription opioids.

When considering physical therapy, ask your health care provider or a community health agency for a licensed physical therapist recommendation and referral. A physical therapist identifies and provides specific help to treat the areas of your body experiencing pain or needing rehabilitation. Individual physical therapy sessions with a trained therapist assist with care and personalized exercises to diagnose, strengthen and prevent further injury.

Common Physical Therapy Goals and Benefits

MSU Extension also offers a variety of programs to learn more about managing chronic pain and staying active:

MSU is an affirmative-action, equal-opportunity employer, committed to achieving excellence through a diverse workforce and inclusive culture that encourages all people to reach their full potential.

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What Are The Best Treatments For Chronic Pain

The best treatments for chronic pain are those that help you experience pain relief. Certain treatments may work better than others, which is why communicating with your doctor and physical therapist is important. For example, if you find that exercise is more effective than medications at reducing pain, your doctor may reduce your dosages or discontinue your medications.

Physical therapy is an ideal chronic pain treatment for those who want to avoid the side effects of medication. Some medications for chronic painparticularly opioids and benzodiazepinescan be habit-forming and lead to dependence and addiction. According to a 2017 study published in the Journal of Manual and Manipulative Therapy, long-term use of opioids for chronic pain is ineffective and increases the risk of death. Other medications such as corticosteroids can become less effective over time.

Dont hesitate to inform your doctor or physical therapist if you feel that a treatment is not working, or you want to try a different treatment. Your doctors will help you find the best solution to reduce and treat your chronic pain.

The Therapist Will Also Show You Exercises Specifically Tailored To Address The Symptoms Related To The Condition

How to Treat a Flare-Up When Working Through Chronic Pain | Pain Science Physical Therapy

These may include:

  • Strengthening your deep neck flexors and muscles around the shoulder blades to help reduce neck tension
  • Stretching the upper trapezius, levator scapulae, scalene, and pectoral muscles

According to a study by Jull and Richardson, 72 percent of patients had achieved a reduction of 50 percent or more in headache frequency at the 12-month follow-up, and 42 percent of patients reported 80 percent or higher relief of some sort. These manipulative maneuvers stimulate neural inhibitory systems at various levels in the spinal cord and activate descending inhibitory pathways. However, physical therapy may initially worsen the headache. Therefore, treatment should be slowly advanced to include gentle muscle stretching and manual cervical traction .

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Can Physical Therapy Reduce Chronic Pain

Yes, physical therapy can effectively reduce chronic pain. It can also help people become more independent.

Pain can often reduce your quality of life and well-being. It can also interfere with your ability to do essential tasks without needing help. Many people with chronic pain feel as if they are burdensome to their family members and loved ones. In addition to reducing pain, physical therapy can help people improve their quality of life.

Spinal Manipulation And Decompression

Spinal manipulation and decompression are some of the most common types of chiropractic care available. Physical therapists and osteopathic physicians also use spinal manipulation in their physical exam practices. Spinal manipulation, commonly referred to as spinal adjustment, involves using the hands or a special device to realign the bones in the spine. If your back pain is a result of misalignment, spinal manipulation can bring you much-needed relief.

Spinal decompression eases back pain by reducing the amount of pressure on the joints and discs in the spine. During a decompression session, motorized traction gently stretches and pulls your spine, moving the discs back into their normal position. If your back pain is the result of a herniated disc or bulging disc, this nonsurgical treatment may help you see an improvement in pain.

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Physical Therapy Tools And Equipment

Physical therapists use a variety of equipment in active physical therapy treatments. The physical therapy tools used in therapy include the following.

  • Items like ankle weights and weighted handballs
  • Recumbent bicycles
  • Kaiser functional trainer for pneumatic resistance
  • TRX for suspension training
  • Range of motion measurement instruments
  • Muscle testing instruments

This is just a sample of the physical therapy tools and equipment.

Pt For Chronic Pain Treatment

How to Exercise with Chronic Pain {Infographic}

You can alleviate your long-term discomfort with a series of therapeutic methods and muscle strengthening exercises. Before we can implement a strategy, youll be evaluated for your range of motion, underlying causes/poor habits, and comfort level with different treatment options. After the consultation, your physical therapist will schedule a series of sessions thatll work to improve your mobility, strength, and posture.

Depending on your specific needs, PT solutions may include hot/cold treatment, cupping, acupuncture, decompression therapy, or massage therapy. To help keep your pain at bay, the exercises and stretches you learn in physical therapy should also be completed at home. When done consistently, these chronic pain treatments will increase the strength of your muscles and work to prevent re-aggravation of your injury.

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Chronic Pain Symptom Relief

Various studies have found physical therapy to be effective in treating specific chronic pain conditions:

  • Knee Pain A study found that patients with osteoarthritis of the knee who underwent physical therapy had less pain and functional disability at one year compared with patients who received steroid injections.
  • Sciatica A study found that patients with back pain from sciatica who were assigned to physical therapy after their initial diagnoses showed less disability and back pain intensity compared with those who were not.
  • Pelvic Pain Physical therapy is also being used to treat chronic pelvic pain. A study looked at patients who had experienced gynecological cancers and found that those who were treated with pelvic floor physical therapy reported a reduction in pain, improvement in sexual functioning, and reduction in urinary symptoms.

It Affects Millions Of Americans

Pain becomes chronic when it lasts for several months or more. Chronic pain is very common. In fact, as of 2019, more than 20% of the adult population in the United States had chronic pain. It often interferes with daily activities and affects a person’s ability to work.

According to the Centers for Disease Control and Prevention 2019 National Health Information Survey, chronic pain affected women more often than men, becoming more common as people aged. About 30% of people with chronic pain were age 65 or older, and it occurred most frequently in the non-Hispanic White population.

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Manual Physical Therapy For Chronic Pain: The Complex Whole Is Greater Than The Sum Of Its Parts

Chronic pain is highly prevalent in the United States, affecting nearly one-third of the American population . The economic impact of chronic pain is substantial with no clear indication that trends will change . In an effort to combat the chronic pain epidemic, pharmacological approaches and specifically opioid prescription have increased exponentially . Unfortunately, these approaches have been ineffective and include considerable risks including addiction and death . Subsequently, non-pharmacological approaches are recommended as a first-line treatment option for individuals experiencing chronic pain . As manual physical therapists, we are well positioned to meet the chronic pain challenge, offering a variety of non-pharmacological treatment options to our patients. Furthermore, our professional organizations are strongly advocating for patients and providers to choose our services over less safe options . For manual physical therapists to play a key role in the management of individuals with chronic pain conditions, simply being a safer option is not good enough. Instead, we must practice in an effective manner as well.

A comprehensive approach to manual physical therapy effectiveness accounting for interactions between patient, therapist, and intervention factors. Examples of factors include preferences, expectations, outcome assessment, and shared decision-making .

How To Know When You Need Surgery

Our Neuroscience Approach to Treating Chronic Pain | Pain Science Physical Therapy

Non Surgical back pain treatment works for many people, but it’s not always the answer. If lifestyle changes and nonsurgical medical treatments aren’t bringing you the relief you need, talk to your healthcare provider about your surgical options. Only an experienced professional can determine if surgery is necessary and likely to relieve your pain.

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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 efficiently 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 , improve the quality of the tissues, and reduce pain.

How We Treat Chronic Pain

Physical therapy is recommended as a first line treatment for chronic pain by the Centers for Disease Control in their urge to reduce the use of opioids in favor of safer alternatives for chronic pain. The benefits of physical therapy include decreased pain, improved mobility, and increased independence as well as reduced risk of other health problems.

A physical therapist will complete a comprehensive evaluation aimed at determining the underlying cause of your pain and will create a customized program to address your needs. This examination may include screening the upper and lower quarter as well as assessing the sensitivity of your nerves. Services may include:

  • Strengthening exercises

*Services are not available at all locations. Call or click the location page near you for that centers services.

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Physical Therapy For Chronic Pain: How It Can Help

Chronic pain is a burden no one should live with. Yet more than 1 in 5 adults in the U.S. have an ailment or injury that causes them to feel pain almost every day. For many, the pain is debilitating enough to interfere with their daily activities or work life.

If you or a loved one suffers from chronic pain, you may be trying or considering different ways to find relief, such as medications, injections, or even surgery. But have you ever thought about physical therapy? If youre looking for a safe alternative to manage your pain, seeing a physical therapist could be a good place to start.

The advantages physical therapy can offer

Physical therapists are movement experts who use prescribed exercise, hands-on care, and education to improve mobility, reduce or manage pain, restore function, and prevent re-injury or disability. There are different types of physical therapy , and attending some weekly sessions can offer several advantages in treating chronic pain.

Chronic conditions physical therapy can treat

Physical therapist William Stanaback, DPT, says most pain conditions can benefit from PT. In many cases, its a good idea for patients to try PT before medication, injections, or surgery, he advises. Some of the most common conditions he treats include:

  • Myofascial pain syndrome
  • Neuropathic pain

Types of physical therapy treatments

  • Neuromuscular education, which retrains the body to perform controlled movement, balance, coordination, and posture
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