How Physical Therapists Treat Pain

How Physical Therapists Treat Pain

Treating chronic pain with physical therapy techniques

Physical therapists are uniquely trained to treat a multitude of painful conditions. For many years, the profession has focused on movement and function—orienting treatment toward those goals and away from pain. However, with the advent of advances in neuroscience research, physical therapists are now better equipped to treat painful conditions, including chronic pain.

Pain has been defined by the IASP (International Association for the Study of Pain) as: “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” This means that pain is an output not an input. It is an emotional reaction to noxious stimuli (nociception). This is a very important concept to understanding pain and our reactions to it.

Chronic pain is a condition lasting longer than three months. If a painful condition (back pain, a sore knee, etc.) lasts longer than this period of time, the brain processes the painful experience in different areas of the brain than acute pain. These areas are more associated with our limbic system, thus influenced more by our emotional being. If we are stressed from work, worried about money, or surviving a pandemic, these factors can influence our pain experience. In some instances, chronic pain can become a condition in and of itself, and traditional medical interventions will not help and can sometimes make the condition worse.

The first thing a physical therapist will do in treating chronic pain is educate you on what is really going on. One session of Pain Neuroscience Education (PNE) can reduce the painful experience by up to 30 percent. Once you understand your condition and how much power you have in the situation, you can start to map your pathway to overcoming it.

One program that has been used to successfully treat patients with chronic pain is Dr. David Hanscom’s Direct Your Own Care program (DOC). The idea is to use education to provide you with more awareness of your condition and your response to it, which can then allow you to separate yourself from your symptoms so that they do not define who you are.

The first thing a physical therapist will do is give you a comprehensive evaluation of your condition. In subsequent therapy sessions, you will be given tools such as diaphragmatic breathing, meditation, guided imagery, relaxation techniques, and advice on posture. These techniques will train your nervous system—specifically the parasympathetic system—to learn how to adapt to stress (including pain) in a more functional way. Manual therapy and therapeutic exercise will also be used to address your specific functional challenges in a progressive program to reach your goals. All the while, the therapist will employ motivational interviewing, active listening, and reframing to help you better understand your condition and its effect on your body.

If you are experiencing chronic pain, contact an MTI clinic near you, to set up an appointment with one of our highly trained physical therapists today.

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Stuart Eivers is a physical therapist at MTI Physical Therapy’s downtown Seattle clinic at the Washington Athletic Club. He has been a physical therapist for 30 years treating a plethora of orthopedic conditions. He has most recently been interested in Chronic Pain and has collaborated with Dr. David Hanscom on several projects in delivering patient education to those suffering from the condition. Stuart has been an international lecturer in the field of Orthopedics and Manual Therapy for many years and is acutely interested in applying the latest neuroscience research to treatment of all his patients.