Physical therapy for chronic pain: how it can help
Chronic pain is a burden no one should live with. Yet more than 1 in 5 adults in the U.S. have an ailment or injury that causes them to feel pain almost every day. For many, the pain is debilitating enough to interfere with their daily activities or work life.
If you or a loved one suffers from chronic pain, you may be trying or considering different ways to find relief, such as medications, injections, or even surgery. But have you ever thought about physical therapy? If you’re looking for a safe alternative to manage your pain, seeing a physical therapist could be a good place to start.
The advantages physical therapy can offer
Physical therapists are movement experts who use prescribed exercise, hands-on care, and education to improve mobility, reduce or manage pain, restore function, and prevent re-injury or disability. There are different types of physical therapy (PT), and attending some weekly sessions can offer several advantages in treating chronic pain.
The program is customized for you
PT can be tailored to address your specific condition and biomechanical issues, explains Summit Health provider Alon Terry, MD, a physiatrist — also known as a physical medicine and rehabilitation specialist — who is an expert in the nonoperative treatment of sports and spine injuries. Biomechanics is how your bones, muscles, ligaments, tendons, blood circulation, and other bodily functions work together to allow for movement.
Physical therapist Anthony Falco, PT, DPT, highlights the amount of time patients get to spend with their physical therapist. “With a 30- or 60-minute session, we can learn about your symptoms, stressors, and lifestyle to design an individualized plan.”
PT can reduce the need for pain medication and invasive procedures
Many chronic pain sufferers turn to anti-inflammatory medications such as ibuprofen, opioids, or other over-the-counter and prescription medications for relief. Unfortunately, these drugs may pose risks, including organ damage with long-term use or overuse, addiction, overdose, and withdrawal symptoms.
“Patients often say they just don’t feel like themselves on a lot of these medications,” says Dr. Terry. “PT and diligent home exercises don’t carry these same risks and ideally allow patients to decrease the amount of medication they take.”
Some people receive cortisone (corticosteroid) shots to manage their chronic pain. But these, too, can have downsides. “While injections can help decrease severe pain and help you get the most out of PT, the effects are often temporary,” says Dr. Terry.
Repeated cortisone injections can also cause a gradual deterioration of joints and tendons, Dr. Terry adds. “PT offers a non-invasive alternative to these interventions.”
An individualized plan will put you in better control of your pain and overall health
PT can make you stronger, help you move better, and allow you to feel more in control of your pain. “PT has the potential to empower patients and give them a sense of ownership over their condition,” says Dr. Terry. Increasing your physical activity can also benefit your long-term health by improving your mood and sleep and reducing your risk of developing many chronic diseases.
Chronic conditions physical therapy can treat
Physical therapist William Stanaback, DPT, says most pain conditions can benefit from PT. “In many cases, it’s a good idea for patients to try PT before medication, injections, or surgery,” he advises. Some of the most common conditions he treats include:
- Back pain
- Neck pain
- Complex regional pain syndrome
- Myofascial pain syndrome
- Neuropathic pain
He also notes that imaging may not be a necessary step to getting better. “In some cases, what shows up on scans is not the source of the patient’s pain,” he adds. “Physical therapists are trained to find the source of the pain, treat symptoms, and guide care based on the patient’s response to treatment methods.”
Types of physical therapy treatments
A physical therapist will develop your treatment plan based on your age, diagnosis, level of pain, and other medical or musculoskeletal conditions. Your treatment plan may include a mix of:
- Low-impact aerobic exercise, such as walking or riding a stationary bike
- Strength exercises using weights, resistance bands, or your body weight, often targeting your problem area and the muscles surrounding it
- Stretching to lengthen tight muscles
- Manual, or hands-on, therapies to ease pain, relax the muscles, and improve range of motion, including:
- Massage and myofascial release
- Joint and soft tissue mobilization
- Muscle energy technique
- Manual traction
- Strain counterstrain manual therapy
- Neuromuscular education, which retrains the body to perform controlled movement, balance, coordination, and posture
- Focused work on posture, ergonomics, and gait to address any bad habits formed over time
Your therapist may also use various modalities to reduce pain. These include:
- Electrical stimulation such as TENS (transcutaneous electrical neuromuscular stimulation)
- Light therapy
- Shockwave therapy
Physical therapist Anthony Falco says education is a core component of PT, even before treatment. “I try to help my patients understand their pain and what’s going on in their body,” he explains. “With chronic pain, the body’s ‘alarm system’ can become uncalibrated. Learning about your pain and how pain works can help you better manage your symptoms and improve both your activity level and function.”
What to expect with physical therapy
During your first PT visit, your therapist will ask about your symptoms and perform an exam to make a diagnosis. Your therapist also will take the important step of discussing your goals as part of developing your treatment plan.
Anthony asks his patients what activities chronic pain prevents them from participating in and what they want to be able to comfortably do again. “Knowing the end goal goes a long way in setting up a plan that will help you comfortably return to the activities you enjoy. We partner with you to make the process as seamless and effective as possible,” he adds.
Some PT exercises may be challenging, and you may feel sore afterward. But this can be an expected part of healing and growing stronger. Communication is the key to progress. “We’ll talk about what feels good, what doesn’t, and what we need to work through or modify,” explains Anthony.
The number of PT sessions you need will depend on your condition, how long you’ve been having symptoms, and your goals. Your therapist will help you set realistic expectations, understanding that everyone responds differently to PT.
“We do our best to give you a timeframe, establish checkpoints, and make recommendations for additional care if needed,” says Anthony, noting physical therapists also work with orthopedic, neurology, and behavioral health providers.
PT may not eliminate your chronic pain entirely, but it can be a safe and beneficial step toward better quality of life. The goal is for you to spend less time focused on pain and more on the things you enjoy doing.
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