Pain management covers a number of areas. The simplest is the treatment of acute pain, whether that be a strained low back or ankle. This is the well know standards of initial immobilisation and application of ice.
However, pain management in more chronic conditions is a wider brief. Long term pain comes with arthritic changes in joints, continuously compromised nerve impingement in the spine and other long term issues following accidents and ‘life-changing ‘events.
As physios, we are well equipped to help you through these.
Listen to the patient
The treatment of chronic pain and the management therein begins with fully understanding the problems the patient has and how it impacts them. This takes a lot of listening and assessment. It is often found that pains come from areas not directly related to the injured tissues. These, once understood, can often be treated by manual therapy and exercise and hugely improved when they were bundled up as part of the whole problem. This is not to say they have been poorly diagnosed by the medics in the first instance but as Physios we have the time and skills to dissect the issues out and not to just take everything on face value.
Secondly, the condition itself needs to be fully assessed to see where it can be improved by manual therapy, exercise and rehabilitation techniques or treatments such as acupuncture. Again, working into the detail of the problem is essential and having the time to do this with these complex cases is where Physios win over the all too brief and often hands-off approach of the medical profession.
Understanding chronic pain
Finally, understanding that pain is a product of the brain and developing mechanisms to deal with that is a fundamental step towards pain management. Physiotherapists are best placed of all the medical professions to work with their patients in this area and to help them develop the individual strategies to manage their conditions.
A useful video can be found here which simply explains the origin of chronic pain. As ever, it is not completely straight forward but this is a good place to start!
Chronic pain is a product of many things and once the injured tissues have settled, usually 3-6 months, the pain felt is produced in the brain by an overactive / amplified neural system. It is finding the keys to get this neural system to settle down and this is a combination of many factors.
The message overall is please do not just put up or give up on improving your pains and problems. With proper management, we can help you.
Examples of patients with chronic pain conditions are:
- Long-term multiple fractures following car accidents – ankles and knees
- Mal-union of fractures
- A poor outcome from total hip replacement – surgical mismanagement
- Chronic arthritis pain in the lower back
- Migraines and facial palsy
- Ehlers Danlos Syndrome