Pain is a normal, but sometimes it’s so excruciating it leaves you numb. Pain disrupts your everyday tasks, making the most menial task seem impossible. When getting dressed is a daunting task, you’ve got problems. And when you need to muster up the courage to tackle a challenge, anticipating the pain – you’re not doing it right. Even something simple like getting a good night’s sleep is a nightmare. A chronic condition is a daily battle, like plantar fasciitis, and you’ll dread those first three steps in the morning. With shoulder impingement pain, washing your hair or taking off a shirt seems like torture. Physiotherapists are medical professionals specializing in mechanical pain from structures like muscles, tendons, joints, and nerves. We use a variety of treatments to help you manage your pain, not only for short-term relief but also to teach you the necessary skills for long-term pain management. Many conditions don’t have a cure, but when you know what you’re dealing with and understand why things are happening – you can control your pain.

What is pain?

Pain seems like such a simple concept that everyone should be familiar with, but in reality it is a complex beast. A beast with an almost infinite combination of components, including biological, psychological, and social factors. It is defined as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (International Association for the Study of Pain).

The value of pain management

Pain management is a medical specialty that focuses on alleviating or reducing pain. Whether your condition causes mild discomfort or severe, debilitating pain, physiotherapists are experts in pain management. We work with you to develop an individualized treatment plan according to your diagnosis and circumstances. The ultimate goal of pain management is to make your life more comfortable and get you back to doing the things you need to do. This does not mean we’ll completely remove the pain, but rather show you the limits of your margin of safety, and how to expand it. Yes, some pathologies are curable, however ignorance and “wait and see” approach risks permanent ireversable tissue damage and pain.

We use pain management to alleviate or reduce pain caused by a variety of conditions or injuries. Physiotherapists are experts at finding the root cause of pain. Pain is only a message, so finding the underlying cause and contributing factors are crucial for effective treatment. It doesn’t matter if you’ve had pain for a couple of days, weeks, months, or even years, your physiotherapist will work with you from day one to take control and manage your pain.

Pain management isn’t a magic trick that instantly gets rid of your pain. But it lowers the intensity and duration of your pain, get you moving again, and boost your emotional well-being. Another valuable outcome of effective pain management is minimizing your reliance on pain medication and giving you other options to get relief.

Benefits of pain management
  • Lowers the intensity
  • Shorter duration of pain
  • Enhance mobility
  • Build strength and resilience
  • Boost emotional well-being
  • Minimize the use of medication

“Medication or surgery aren’t your only options when it comes to pain management.”

Different options for pain management

A physiotherapist uses many different types of pain management techniques and approaches. The treatment techniques we use depends on the underlying cause.

How your body responds when you are in pain:

  • Nervous system response: Tissue damage (or potential tissue damage) will trigger special receptors in your body. These receptors send signals to your brain, which interprets the sensation as pain.
  • Physical response: Your body’s response to pain will depend on the type and severity of your pain. These responses include tensing muscles, flinching, or movement to get away from whatever is causing the painful sensation.
  • Increased heart rate and blood pressure: Pain triggers your body’s fight or flight response. Elevated heart rate and blood pressure are signs of this response.
  • Release of stress hormones: Pain brings about a stress response, and your body’s natural reaction to stress includes the release of stress hormones like cortisol and adrenaline.
  • Inflammation: Tissue damage triggers the release of inflammatory chemicals that cause swelling and redness in the injured area.
  • Emotional response: In most cases, pain causes a strong emotional response. Feelings of frustration, anxious, irritable, or depressed when you’re in pain. In practice, we see that pain, anxiety, and depression often go hand in hand.

Changes in your body with appropriate pain management:

  • Nervous system changes: When you have pain, your nerves “overreact” to normal sensations like pressure or movement as if these sensations are harmful. If the correct techniques and approaches are used to treat your pain, we desensitize your overactive nervous system back to its pre-injury state.
  • Physical changes: Effective pain management results in decreased muscle spasm or tightness, improved mobility, and decreased swelling.
  • Physiological changes: Reduction in pain intensity will lower your body’s fight or flight response. This means that your heart rate, blood pressure, and stress hormones will start to return to pre-injury levels.
  • Healing response: As your pain decreases, your body gets back to its normal business of healing the injury. Movement is medicine, so the sooner we get your pain under control, the sooner we’ll get you moving and healing.
  • Psychological changes: As your pain improves you will find that you aren’t constantly aware of your pain, and spend less time worrying about your injury until the time comes when you forget that you even had pain.

How long does it take to get pain relief with physiotherapy?

Healing times vary, depending on your specific condition, but physiotherapy aims to speed up and magnify the positive results. Other factors like your overall health, age, gender, previous injuries and medical history, and even your occupation or sport affect the recovery time. In some cases, pain relief could be immediate, while in other cases it may take several sessions to achieve significant pain relief.

Physiotherapy treatment aims to not only reduce your pain but also improve function, and promote healing. The specific techniques used in physiotherapy include exercises, manual therapy, modalities such as electrotherapy, heat or ice, and education on pain science, posture, and body mechanics. The list is extensive, but we’ll prioritize the hierarchy of targets for your specific injury, in order to achieve faster results.

It’s important to keep in mind that physiotherapy is most effective when it is part of a comprehensive treatment and rehabilitation program. Your physiotherapist will work with you to develop an individualized treatment plan that is tailored to your specific needs and goals. We’ll monitor your progress throughout the course of treatment and adapt constantly.

Can I stop using pain management techniques when I feel better?

If you have a chronic or recurring pain condition, it’s important to continue using the pain management techniques that your physiotherapist taught you, even when you start feeling better. These techniques are not only for pain relief during a flare-up but also for managing future pain episodes. When you’ve been living with a systemic condition all your life, you know it’s not going away any time soon, but we can help you take back control and build resilience.

If you stop pain management techniques once you start feeling better, the risk of pain coming back increases and, eventually, leads to a setback in your recovery. You will work closely with your physiotherapist to develop a long-term plan for managing your pain. Remember that pain management is an ongoing process, and it may take time and effort to find the right combination of techniques that work best for you. Be patient, and stay committed to taking an active role in managing your pain.

Is there anything I can do at home to manage my pain?

  • Apply heat or cold – your physiotherapist will advise you on which one to use for your specific condition.
  • Take pain medications as prescribed by your doctor to take the edge off.
  • Practice relaxation techniques such as deep breathing.
  • Exercise within limits of your pain. A physiotherapist will guide you with the correct exercise program.
  • Massaging the affected area help promote blood flow and reduce muscle tension.
  • Pacing: Be as active as your pain allows, but rest as often as you need to.

Cost of physiotherapy for pain management

Every single treatment technique applied during a physiotherapy session is used to treat pain. Even though we’re dubbed ‘terrorists’ and torturers, we’re capable of relieving the pain just as easily. Some techniques are pain provoking, but rest assured your physiotherapist is equipped to ease it again. We’re confident in our skills to achieve a goal – even if that means you’d have to endure some short-term pain. We are passionate about helping you overcome your pain, so you will never only be paying for machine treatments or hot packs. The value comes from us listening to your story and working with you to create a treatment plan to manage your pain according to your needs and circumstances.

Medical Aid Codes

Techniques used for pain management can include rehabilitation and education (501), counseling (708), joint mobilization (401 or 405), myofascial release (303), massage (302), neural mobilization (310), dry needling (328), strapping/immobilization (407), laser (006), ultrasound (203), interferential therapy (107), and re-education of movement (305).

When used in isolation, you may get some relief from these techniques and modalities. However, the true value comes in when an experienced, knowledgeable physiotherapist uses the right combination, chosen specifically for your injury or condition.

Does it make a difference to go to an experienced physiotherapist to treat and manage my pain?

Yes, it makes a significant difference. A Physiotherapist is not a GP, masseuse, biokineticist, or chiropractor. The core of effective pain management is understanding what exactly you’re dealing with before you start treatment. Lack of a clear diagnosis is the number one reason for failure and frustration in the recovery process. An accomplished physiotherapist has the necessary background knowledge in pathology, anatomy, and physiology combined with the skills to assess your problem, diagnose it, and rank the priorities. This enables us to develop an individualized treatment plan and deliver effective interventions to manage your pain and promote healing.

A physiotherapist with years of hands-on experience will likely have seen and treated conditions similar to yours. This knowledge and experience allow them to identify contributing factors and give you the necessary information and explain the extent of the problem. They elaborate in understandable terms and guide your expectations of recovery. A skillful therapist doesn’t get flustered if there are bumps or setbacks on your road to recovery, they know it’s part of the process. They will adapt your treatment plan instead and keep the end goal in sight. Constant reassessment, feedback, and reassurance are important features of an effective pain management program.

Seeking treatment from a team of experienced physiotherapists is vital in truly managing your pain and boosting recovery.

When will your physiotherapist refer you to a specialist or for scans?

  • When the recovery doesn’t follow the normal course as expected.

  • Only to exclude more serious conditions

  • Worsening neurological symptoms

  • Clinical findings don’t “match” the intensity of the pain

  • Suspected fractures

  • Possible disorders that will need further testing and medical treatment

  • Severe pain that doesn’t respond to conservative management within a specific timeframe (depending on your diagnosis)

Frequently asked questions about pain:

Injuries, surgery, inflammation, or a chronic conditions like osteoarthritis.

Physiotherapists diagnose the cause of your pain based on your symptoms, medical history, and a physical assessment. Their extensive knowledge of physiology, anatomy and pathology teaches them to identify the culprit. Just like a mechanic fiddles around in the engine and runs some stress test, a physiotherapist knows how the muscles, tendons and joint react to specific forces.

Some of the treatments include medication advise, physical therapy, injections, nerve blocks, cognitive-behavioral therapy, and surgery.

For some patients, it may be possible to eliminate or significantly reduce pain through appropriate treatment. However, for others, pain management may be a long-term process focused on managing symptoms rather than a cure.

Pain is only a symptom, then end result of a problem somewhere in your body. You have to find and treat the root cause of your pain. Our physiotherapist diagnose the problem before we start changing it.

Chronic Pain, Acute pain Management