Chronic Pain and Physical Therapy

Chronic pain is a condition that occurs when the brain concludes there is a threat to a person’s well-being based on the many signals it receives from the body. This condition can and often does occur independently of any actual body tissue damage (due to injury or illness), and beyond normal tissue healing time.

It is estimated that 116 million Americans have chronic pain each year. The cost in the United States is $560–$635 billion annually for medical treatment, lost work time, and lost wages. The causes of chronic pain can vary and while any condition can lead to chronic pain, there are certain medical conditions more likely to cause chronic pain including:
– Trauma/injury
– Diabetes Mellitus
– Fibromyalgia
– Limb amputation
– Reflex Sympathetic Dystrophy
– Some diseases, such as cancer and arthritis, cause ongoing pain. With chronic pain, however, pain is created in the nervous system even after physical tissues have healed.

Chronic pain affects everyone differently. In some cases, chronic pain can lead to decreased activity levels, job loss, financial difficulties, as well as anxiety, depression, and disability. As physical therapists we work with you to lessen your pain and restore your activity to the highest possible levels. With treatment, the negative effects of chronic pain can be reduced.

What Is Chronic Pain?
Pain is an unpleasant sensation that we usually associate with injury or tissue damage, but can actually be present in the absence of tissue damage as well. Pain can be acute or chronic.

Acute pain
lasts for a short time – up to 12 weeks. It is a warning that tissue damage has occurred or may occur, or to help us prevent injury or disease. For instance, if we touch a hot stove, the body sends a danger message to the brain that there is a threat to tissues in order to prevent further injury. A sore foot can signal a need to change your footwear. In some cases, the danger messages may be due to some disease process, and your brain may interpret those messages as pain. This can cause you to seek medical attention – diagnosis and treatment – for what may be a serious condition. Signaling pain in this manner is the body’s way of protecting us and is a good thing.

Chronic pain
is any discomfort or unpleasant sensation that lasts for more than 3 months, or beyond an expected normal healing time. Often, those who have chronic pain believe they have an ongoing disease or that their body has not healed, when this may not be the case. Chronic pain is likely not warning you of possible injury or danger; instead, the pain centers in the brain may be causing you to hurt even though there are no new causes of pain occurring in the body. Anyone can develop chronic pain, at any age.

How Does it Feel?

Common complaints related to chronic pain include:
– Everything hurts, everywhere
– Sudden stabs of pain
– It may seem as if the pain “has a mind of its own”
– You feel symptoms even if you are not doing anything to cause them
– It feels worse when you think about it
– It feels worse when you experience upsetting circumstances in your life
– You may feel more anxious and depressed
– You may feel your symptoms spread from one area to another area
– You may feel fatigued, and afraid to do your normal activities

These complaints are common when you have chronic pain. However, it does not necessarily mean that your physical condition is worsening; it may just mean that your system has become more sensitive.

Signs and Symptoms

Research finds the following signs may be associated with a chronic pain syndrome:

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 a tendency to increase their medication over time to seek relief.

How Can a Physical Therapist Help?

We will work with you to educate you on chronic pain, find solutions to improve your quality of life, and get you moving again! We will help you improve movement, teach you pain management strategies, and, in many cases, reduce your pain.

While not all chronic pain is the same, we will evaluate your clinical examination and test results and design an individualized treatment plan that fits you best. Treatments may include:
– Education to improve your knowledge and understanding of chronic pain
– Strengthening and flexibility exercises to help you move more easily with less discomfort
– Manual therapy
– Posture awareness and body mechanics instruction to help improve your posture and movement

If you feel that you have been suffering from chronic pain, give us a call today. We can assess your situation and determine if physical therapy is right for you.

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