One in five Canadians report experiencing chronic pain – that’s equal to over 7 million people from all ages. Three quarters of these people say their pain interferes with their work life.1 This may include you, your family members, friends, or co-workers.
What is Chronic Pain?
Chronic, or persistent pain, is pain that lasts for weeks, months or years after an injury or illness or recurs even without a new injury.1 The pain may start with a minor injury or illness, but instead of the pain getting better as the injury heals or as you recover, the pain continues. Chronic pain may also occur even without an injury or illness.2 Over time, the pain makes it increasingly difficult to move, work, and enjoy a normal life. Simple things like touching the skin, stretching, or moving muscles may become unbearably painful.1 Sometimes you have pain even when you are doing nothing.
Thankfully, there is hope. Chronic pain is not imagined or exaggerated but is likely caused when our brain and nervous system becomes hypersensitive or “turned on” and interprets even non-painful stimuli as being painful. This rewiring of the nervous system is called “central sensitization” and can result in you feeling pain with activities, movements, or being touched.1
Take for example, touching the skin lightly. This usually does not hurt when the nervous system is working normally. The nerves send a message of light touch to the brain and the brain tells you this is normal light touch and is not a threat. With chronic pain, the system becomes “rewired” and the messages from the skin are interpreted in the brain as pain signals instead of touch signals.1
If you have experienced pain in the past, you may begin to expect an activity or movement to be painful, even though this may no longer be the case. So, you avoid doing that activity hoping to avoid pain or prevent further harm. This fear can greatly limit your activity preventing you from doing the things you want to do.3
How is Chronic Pain Treated?
There is no “quick fix” for chronic pain, but the good news is that you can learn skills that will help you manage the condition and continue to live a full and active lifestyle despite your chronic pain. This is where your physiotherapist can help.
If you have developed chronic pain, then your physiotherapist can help you manage your condition by increasing your understanding of chronic pain, as well as strategies you can use for living with the pain and leading a full and active life.
Your physiotherapist will take a full history and listen to you describe your pain experience. They will then complete an assessment to identify any physical reasons for your pain and provide a treatment plan to address these. They will also use this evaluation to identify other resources or health-care providers that could assist you managing your pain, or if any further investigations may be required. Physiotherapists work closely with other health-care providers involved in your care. Chronic pain management often involves a team of health providers working together and your physiotherapist is an important part of this team.
Your physiotherapist needs to understand you and your individual situation so they may ask you questions about:
Your pain - how do you describe it and how does your pain impact you, your life/leisure/work and or your family?
What activities or movements cause you to experience the pain, when this happens, how long does the increased pain last and the level of pain you experience?
What activities, positions or techniques do you use to try to manage or decrease your pain when it occurs?
What activities have you stopped doing because of your pain?
How does your pain make you feel and what do you think about your pain?
Physiotherapists can then provide you with:1
Education about your pain and chronic pain in general – what it is, what it is not and how your beliefs about your pain may be contributing to your experience.
Help to recognize and accept that your pain experience is real but may not be tied to actual or potential injury/harm.
Self-management strategies, including goal setting, relaxation, imagery and/or breathing techniques.
An individually designed program of exercises and graduated activity to increase/improve physical activity and function and help you to return you to the lifestyle you want.
Help to unlearn some of the abnormal postures and movements your body may have adopted to guard you from the pain.
With the help of a physiotherapist, you can start to get control of your pain. Ask your physiotherapist about other resources available to support you and help you manage your pain.
Physiotherapy may also help you before your pain becomes persistent. Early treatment of acute or painful injury or illness may help prevent, or decrease, the risk of developing chronic pain. By addressing your injury or illness early on and following the advice and treatment plan of a physiotherapist, you can return to your normal activity and lifestyle.
To find a physiotherapist that treats chronic pain, click here.
Chronic Pain Management: A Toolkit for Physiotherapists. https://www.physiotherapyalberta.ca/xchange/continuing_professional_development/elearning_center/chronic_pain_management_a_toolkit_for_physiotherapists/#sources Accessed Dec. 5, 2017.
International Association for the Study of Pain. IASP Taxonomy. Available at https://s3.amazonaws.com/rdcms-iasp/files/production/public/Content/ContentFolders/Publications2/ClassificationofChronicPain/Introduction.pdf. Accessed on December 15, 2017.
Bostick G, & Wideman T. Chronic, complex pain – What can I do in 15 minutes? Physiotherapy Alberta recorded webinar. Available from: https://www.physiotherapyalberta.ca/xchange/continuing_professional_development/elearning_center/chronic_complex_pain_what_can_i_do_in_15_minutes/?course_type%3Alist=Recorded+Webinar&search_term=pain. Accessed December 14, 2017.