Physiotherapy for Chronic Pain: It's More Than Physical

Physiotherapist Assessing Chronic Back Pain

If you've experienced chronic pain you'll certainly be aware that it affects more than just your body. As a holistic practice, Remedy understand this and view each patient as more than just the physical injury they present with.

In keeping with Mental Health Awareness Week, we wanted to share our thoughts on some of the often-overlooked psychological concepts associated with chronic pain and how physiotherapy can help.


The Psychology of Chronic Pain


Chronic pain is defined as pain that is ongoing and usually lasts longer than 3 months. It is a pain often associated with injury or illness.

Pain is both a physical and psychological experience. Although it is the body that receives the stimulus, pain is registered, processed and perceived by the brain.

Patients with chronic, persistent pain have a very different experience because our perception and sensitivity to pain change with long term exposure. Therefore, chronic pain often continues long after the physical injury or illness itself has resolved due to heightened pain signals remaining present.

Examples of chronic pain conditions include; fibromyalgia, arthritis, lower back pain and multiple sclerosis (MS). People with these conditions often find that they also experience depression and clinical studies suggest the two are deeply linked.


Psychological Responses to Chronic Pain


As physiotherapists we regularly encounter the following responses to chronic pain:

  • Learned Helplessness

Learned helplessness is where a person has suffered a stressful or painful situation repeatedly. They eventually reside to a belief that they are unable to control or even help their own situation. Often the sufferer becomes reluctant to try when opportunities to change present themselves. This self-limiting cycle can go on forever with disastrous consequences if left unchecked.


  • Fear and Pain Avoidance

Also known as Catastrophizing, activity avoidance due to fear and pain is a response deeply embedded in our ancestral behaviour. In principle, the response is designed to protect us from harm. However, if misinterpreted this can lead to disuse, depression and disability through the absence of physical activity.


Our Physiotherapists' Approach


It's common for physiotherapists to encounter chronic pain in clinic. Less common is an approach that seeks to address the surrounding issues as well as the physical presentation of pain.

At Remedy, our physiotherapists have post-graduate qualifications in a number of holistic approaches that can help. These include:


  1. Pain Relieving Modalities


    Acupuncture, massage, joint mobilisation and electrotherapy have all been proven to relieve pain-related symptoms in the short term.

    In addition, they have far fewer side effects or complications than traditional analgesic medication.


  2. Physical Activity


    As previously eluded to, fear and pain avoidance often leads to a dramatic decline in physical activity.

    Continuation of physical activity is critical, as it not only benefits the muscles, heart and lungs, but also boosts mood through the release of certain neurotransmitters.

    Both prescribed physiotherapy exercises and general promotion of physical activity is the cornerstone of any approach to chronic pain.


  3. Cognitive Behavioural Therapy (CBT)


    CBT equips people to deal with chronic pain by helping them to recognise negative patterns in their thoughts and behaviours and reframing them.

    An important aspect of this is staying present; not worrying about the future or dwelling on the past. This practice, known as mindfulness, can help patients to change their perception of pain.

    Goal setting also helps the person to focus on what can be controlled in the here and now. This focus on what can be achieved generally leads to more positive choices, instead of the thoughts and behaviours that often maintain and even worsen the experience of chronic pain.


  4. Patient Education


    This is probably the most overlooked element of all medicine. Due to busy clinics and time-restricted appointments, the vast majority of patients leave without a decent understanding of their diagnosis and often struggle to describe it.

    Here at Remedy, our physiotherapists take the time to ensure you're educated on your condition. Increasing your knowledge allows you to better make sense of your pain and guides you towards effective management strategies.

    Patient education is key to helping you take control of your present and future health.


Get Started with Physiotherapy at Remedy


It's important not to delay seeking treatment when you're experiencing pain. Remedy can help you to resolve or improve your chronic pain and avoid the pain cycle that can begin to negatively impact not just your physical but also your mental health.


To discuss your condition and start the journey back to feeling like yourself and doing the things you love, book your free physiotherapy consultation today.