Pain that persists 

What is chronic pain?
Chronic pain is typically defined as pain that persists past the normal time it takes for tissues to heal or pain that persists beyond 3-6 months.

To understand chronic pain, it is important to know how pain works.
With any injury, the tissues that are damaged send signals through our nerves to the brain to tell us that there is danger and that something is wrong. The brain then responds by sending back pain signals to the damaged tissues, so we know to take ourselves out of danger and to rest and recover. Tissues like muscles and ligaments can take 6-12 weeks to heal depending on the severity of damage while bones can take a few months. As we heal, the tissues send fewer signals to the brain and in return, the sensation of pain slowly goes away.

In some cases like arthritis, chronic pain is often diagnosed due to the nature of the condition. Arthritis is a progressive, degenerative condition where the tissues will continue to send intermittant alarm signals to the brain when they are overloaded or put through too much strain.

Other times, the damaged tissues may be healing but the signals between the tissues and the brain continue on. The cause of this is not always clear but can be because the alarm or danger signal receptors in the healing tissues continue to be replaced instead of reducing their numbers or, the nerve fibers that send the signals become confused.

The brain can also affect the amount of pain as our emotions are closely linked to the part of the brain that processes these danger tissue signals. If we are stressed, anxious, unwell or angry, our pain symptoms can feel worse as the brain fires more signals. If we are happy and well, the part of our brain that processes pain will be less excitable, firing fewer signals and in return, we may feel less pain.

The impact of persistent pain goes way beyond the pain itself and chronic pain can have an impact on relationships, finances, mental health, sleep and work.  Being in pain constantly is exhausting and wears you down - beginning to understand the science of persistent pain is the first step in taking back your life.  The complex nature of chronic pain requires a multidisciplinary approach often involving your doctor, specialist, physio, psychologist and exercise physiologist.   Finding your team of health care professionals is important and not always easy.  

Seek out professionals with a particular interest in and experience managing persistent pain for your best results. 

How is chronic/persistent pain managed?

The main aim of chronic pain management is to understand how chronic pain works and to improve quality of life by reducing the impact of pain in your day-to-day activities.

Treatment may include:

  • Pain education - knowledge is power - taking control and staying positive can help reduce symptoms
  • Hands on treatment like massage and joint mobilisation
  • Acupuncture or dry needling
  • Improving your well-being through activities or hobbies that you enjoy
  • Exercising to help strengthen and stabilise the affected area. " Movement is medicine" 
  • Practicing mindfulness and meditation - this can help dampen the pain response and threshold to pain 
  • Hydrotherapy and aquatic exercise can be useful if land based exercise is not possible or ideal
  • Braces and supports can help if they allow people to move and exercise more (eg a lumbar corset of brace may allow someone to walk more or further ) 
  • Pain medication may be useful if used well and in conjunction with active therapy and exercise 

How can physiotherapy help with chronic pain?

It is very common for someone with chronic pain to see a physiotherapist. Your physiotherapist can supply hands on treatment where needed but will also focus on providing a treatment plan that will help to make physical changes in an aim to minimise how pain may limit your daily activities.

Here at Revive, our physiotherapists have experience supplying postural advice, chronic pain education, hands on treatment and home exercise programs for individuals with persistent pain. Revive also offers exercise therapy sessions where you engage in a tailored exercise program integrating rehabilitation tools, therapeutic exercise and Pilates. This is an excellent way to help strengthen and stabilise the affected area, work towards your own exercise goals and improve your pain tolerance and fitness for daily activities in an aim to invoke long term changes.

We aim to empower people with persistent pain by giving them the tools to manage their pain thereby reducing the emotional  and psychological burden of being in constant pain.   It's important to consult with a healthcare practitioner that understands the science of persistent pain and can help you get back to loving and enjoying life.