This is the third and final article regarding chronic pain. In the last two articles we reviewed the differences between acute and chronic pain, some particular medical conditions that can lead to or impact chronic pain and common complaints associated with chronic pain.
There are also some signs and symptoms related to chronic pain:
- It is easy to begin to fear increased pain when you have a chronic pain condition. As a result, you may begin to avoid activity. You may find that you rely more on family members to help with daily functions.
- Body stiffness when you try to become more active. Stiffness may make you feel as if your body is less able to perform daily activities.
- Not moving your body results in less tolerance when you want to become more active. If you are inactive for a long time, muscles weaken and shrink from not being used. This can also increase your risk of falling.
- Decreased circulation. Lack of activity decreases the circulation of much-needed blood to your cells. Tissues in your body may not get as much oxygen as they need. As a result, they may not be as healthy as they can be. This can cause you to feel fatigued, and lack energy.
- Weight gain and/or a worsening of other conditions. Decreased activity can lead to unwanted weight gain. Added pounds and inactivity can aggravate symptoms of other conditions such as diabetes and high blood pressure. Chronic pain conditions are also commonly associated with feelings of anxiety or depression.
- Increased use of medication. Chronic pain patients can have the tendency to increase their medication over time to seek relief.
Living with chronic pain is very difficult. Often we begin to change our behavior. We are all different in how we approach long term pain. Some Individual behaviors may include:
- Seeking out multiple doctors or health care providers and facilities to find relief.
- Difficulties with job performance. Some people with chronic pain even seek work disability.
- Avoidance of social situations or family members.
- When pain is ongoing, you may find you have feelings of bitterness, frustration, or depression. Some people report they have thoughts of suicide. If you are having these feelings, tell your doctor. This is important, so that you can get appropriate medications to help you feel better.
One thing that many people find that helps is seeking the help of a physical therapist (PT). A 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 easily 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 (range of motion), improve the quality of the tissues, and reduce pain.
- Posture awareness and body mechanics instruction to help improve your posture and movement. This training helps you use your body more efficiently while performing activities, even when you are resting. Your therapist will help you adjust your movement at work, or when performing chores or recreational activities, to reduce your pain and increase your ability to function.
- The use of ice, heat, or electrical stimulation has not been found to be helpful with chronic pain. Your physical therapist, however, will determine if any of these treatments could benefit your unique condition.
Some do’s and don’ts with chronic pain are:
- Avoiding bed rest. Long periods of bed rest will not improve your pain and may make it worse. Prolonged bed rest puts you at risk of other complications as well, including increased muscle weakness, bone loss, weight gain, and poor circulation.
- Improving posture. Your therapist will help you adjust your posture so your body can work at optimal efficiency to reduce joint stress and help to reduce your symptoms.
- Performing exercises to improve and restore your sense of the involved body area. Your therapist will also teach you exercises to restore movement (range of motion), mobilize nervous tissue (main component of nervous system), and rebuild your strength for performing routine daily activities.
- Introducing meditation, relaxation, and imagery exercises to help reduce stress and muscle tension.
- Learning fully about your condition. This will help you better understand what is occurring in your body, so you don’t worry about every new ache, pain, or symptom.
- Maintaining healthy activity levels and improving your overall health.
The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternative of physical therapy for long-term pain management. For more information go to moveforwardpt.com
Katesel Strimbeck PT, MS is the Director of Rehabilitation Services at North Country Hospital. Katesel has been a practicing PT for 20 years. She is a member of the American Physical Therapy Association (APTA).