10 Questions about Pain with a Physiotherapist

August 3, 2021

1 – What is pain?

Pain is an unpleasant sensory or emotional experience. It can be a response to many factors, such as stress, threat, damage to a tissue or a physical/neurological condition.

Pain is a general term that describes uncomfortable sensations in the body. It stems from activation of the nervous system. Pain can range from annoying to debilitating. It may feel like a sharp stab or dull ache.

People feel pain when a signal travels through nerve fibers to the brain for interpretation.

Whilst pain can cause severe discomfort and can be extremely debilitating, there are many wonderful Physiotherapists that can help individuals manage and reduce their pain!

2 – What is involved in an assessment when pain is the nature of the complaint?

The first part of the assessment is to review our patient’s history extensively. We might ask:

  • How did it start?
  • What makes it better or worse?
  • Where is the pain located?
  • Has it improved or exacerbated over time?

After a thorough subjective assessment, our Physiotherapists typically begin physical testing to review:

  • how the patient is moving
  • how various pressures change the pain
  • Strength
  • ROM
  • how their body reacts to various movements.

Clinicians may use the Brief Pain Inventory or the Pain Rating Scale, which are pain measurement questionnaires that will help us quantify the pain levels and ideally, improve upon them!

3 – How would services vary if the patient is unable to communicate?

This starts with a full understanding of medical history and current pain medications. It also depends on the communication challenge (i.e. blind, deaf, etc).

If the patient is unable to communicate verbally, we pay close attention to their body language and facial expressions as this can be indicative of pain. There are some non-verbal pain management scales (such as the Abbey Pain Scale, which was largely developed alongside dementia patients) as well as observational objective measures.

In cases where the patient is living with a neurological condition, we would typically focus our tests on the nerves themselves. In many cases, pain is related to shortening or lengthening of the nerves (i.e. testing hamstring flexibility), pressure, reflexes and strength.

4 – What is the difference between acute and chronic pain?

Acute pain is typically associated with an injury to the tissue that causes an inflammatory response and healing in under three months – therefore its regarded short term.

Chronic pain is defined as pain that lasts for longer than three months. Chronic pain can persist after a tissue has fully healed. Typically, this pain will relate to the Central Nervous System (CNS). As an example, a CNS response could be described as over-sensitive and is causing recursive pain.

5 – What are the primary ways most individuals can reduce their pain with the help of Physiotherapy?

  • General education
  • Lifestyle modifications
  • Manual therapy
  • Stretching
  • Hydrotherapy
  • Exercise
  • Massage
  • Balance work
  • Rehabilitation equipment

6 – What are some lesser-known pain management strategies?

  • Mirror therapy
  • Detailed pain education
  • Graded exposure – useful for people who are fearful of a certain activity
  • Pacing – planning the day to perform activities that will build capacity
  • Music therapy
  • Breathing exercises

7 – What are the lifestyle factors that we can control that may lower pain?

  • Weight
  • Diet
  • Amount of physical activity
  • Smoking
  • Stress
  • Alcohol
  • Sleep
  • Home environment
  • Assistive equipment
  • Footwear
  • Beliefs/behaviours
  • Social factors

Total Health Physio provides holistic healthcare. We also employ wonderful Occupational Therapists and Exercise Physiologists who may assist.

8 – What would be inside a pain management program for an individual?

An example would be if a Total Health Physiotherapy patient presented with ankle pain we would:

  • Examine the condition to diagnose the cause of the pain
  • Perform specific assessments of the ankle
  • Explain the condition to the patient
  • Take into account patient goals
  • Treat the ankle using evidence based therapy
  • Provide education on rest, rehabilitation and other supports
  • Create an individualised exercise program with specific exercises, sets and repetitions
  • Develop Exercise progression and home exercise program
  • Review goals and objectives

We would detail this information and store this on our patient’s file. The patient will be issued documentation with their exercises and this will be updated regularly.

9 – Are there pain management specialisations for Physiotherapists?

Yes. There are many different pain specialisations, such as:

  • Working inside pain management wards of hospitals
  • Postgraduate degrees
  • Focusing on a particular body part, such as Orofacial pain

10 – How does Total Health Physio help the community manage or reduce pain?

Total Health Physio is proud to employ a team of clinicians who are experienced in pain management.

  • We have extensive knowledge of pain management with years of experience working in community and residential settings
  • We are experienced with ACFI 4A and 4B pain management programs
  • We provide pain management solutions for NDIS, Home Care Package and residential aged care Physiotherapy patients
  • We provide holistic services
  • We live by our motto of providing healthcare with Trust, Compassion & care

If you know someone who might benefit from services from Total Health Physio, please use our contact page to get in touch!

We’d love to hear your story and help make a difference to your life by reducing your pain!