Updated: Oct 16, 2020
What is pain?
- Pain is an unpleasant sensory and emotional experience associated with an actual or potential tissue damage (Lehman, 2019).
- Chronic Pain is described as pain which carries on for longer than 12 weeks despite medication or treatment and may or may not be associated with tissue damage.
- Pain can be seen as an alarm.With an acute injury the pain alarm can be helpful to prevent further injury, for example pain can stop you from walking on a broken leg. However, pain no longer becomes useful as an alarm when it begins to persist over a longer duration, as it often means it is disconnected from the initial problem.
- Chronic Pain is multi-dimensionaland can cause psychological distress, negative beliefs, social withdrawal and reduced activity. These can all lead to fear of injury recurrence which often leads to inactivity, in turn delaying the progression of recovery and increasing the risk of physical and sometimes medical decline.
- When you are in pain, your tolerance to doing physical activity or other stressful activities can be reduced, resulting in you becoming sensitized and finding activities that were once easy more difficult and painful. Often, resting and avoiding activity can make your sensitivity to pain worse.
- To build up your tolerance to these activities again, it is important to begin stressing the body again slowly, building up your resiliency and increasing your pain sensitivity threshold.
- It is important to remember that if you have had pain a long time, your body and brain will have adapted slowly. Therefore, it is important to have patience and perseverance on the road to recovery.
Pain and tissue state are poorly related ‘Not every hurt equals harm’
- 57% of 20 to 50-year olds with no hip pain have been shown to have cartilage and ligament tears (Tresch, 2016)
- Labral tears in the hip are common in people with and without accompanying pain
(62% of individuals had a painful hip, 54% had asymptomatic hips)
- Sandal et al, (2016) reported that in patients with persistent knee or hip pain, acute exercise-induced pain flares during an 8-week rehabilitation program are expected. Furthermore, these flairs were transient and gradually lessened throughout the program, decreasing significantly after 8 weeks.
- Chronic pain and tissue damage seen on clinical imaging such as MRI are poorly corelated
- Arthritis on an X-ray can occur with a patient that experiences no pain in that area
Myth – Rest is Best
- Pain can result from too much or too little activity (Abenheim et al., 2000).
- 1/3 of children who develop knee pain are sedentary (Khan and Scott, 2009).
- Exercise can be challenging for a fearful or sensitized person, but it has been demonstrated that exercise can increase pain tolerance (Rio et al., 2015).
How can physiotherapy help you with your pain?
- Our Physiotherapist will help to assess and screen your presenting complaint, whilst prescribing efficient and individualized treatment plans to help you get towards your goals.
What might we do as the treatment?
- This will largely depend on the interview and movement assessment we carry out and the findings from this. However, things this may include are:
- Goal setting and establishing what you want to get back to whether it be play with your children, grandchildren, get back into cycling, running or simply feeling more confident to leave the house with your pain under control
- Evaluating and strengthening the relevant musculature
- Increasing coordination and endurance in the ailing muscles and surrounding supporting structures
- Working to improve balance and posture, particularly if the injured area is influenced by these
- Recommending appropriate pain relief techniques
- Education surrounding your pain and the effective management of your pain
- Education surrounding pacing strategies
- We will discuss your preferences to ensure the treatment plan is appropriate for you, which will ensure we can work optimally towards helping you achieve your goals
Book your appointment with Limitless Physiotherapy today or contact us to find out more at:
Greg Lehman (2019) Pain Science Ebook.