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Rehab Insights is a weekly blog written by Burke Rehabilitation professionals to offer practical information for patients, families and the community. Its goal is to educate the reader on relevant topics in rehabilitation, general health and wellness.

What to Know About Physical Therapy for Pain Management

December 15, 2019

When you’re experiencing pain, there’s no doubt you’re on the search for a way to feel better. And you’re not alone: Roughly 20 percent of the population experience chronic pain, according to the CDC, with the National Institutes of Health calling it a “silent epidemic.”   

“The prevalence of chronic pain and the increasing use of opioids—which have led to addiction and fatalities—have led to increased efforts to address chronic pain in other ways,” explains Ben Gilbert, PT, MS, MBA, OCS, Cert. MDT, Director, Outpatient Rehabilitation, Main Campus at Burke Rehabilitation Hospital. One of those ways: physical therapy. “Physical therapy (PT) has become a recommended part of a ‘blended approach’ to dealing with this problem.”

He explains: “Physical therapy is one of the best and safest choices you can make when you have long-term pain (also called chronic pain). It can make you stronger, more flexible, and help you move and feel better without costly surgery or excessive pain medicines.”

A physical therapist can also help you get to the source of the pain. “Therapists will look for areas of weakness or stiffness that may be adding stress to the places that hurt—and they will treat those areas with certain manual techniques, modalities and exercises to ease pain and help you move better. By treating the pain at its source, physical therapy can prevent recurrence better than merely treating the symptoms.”

If you’re considering physical therapy for pain management—or it has been suggested by your physician—here are some important things to know:

Physicians regularly recommend PT—and research shows benefits. As the statistics indicate, chronic pain is a big problem—and doctors are taking note of PT as an option. “Pain has become a common reason for referral for PTs from primary care physicians, along with specialists,” explains Gilbert. And there is research to prove this has benefited patients, he says, citing a study published in Health Services Research. From an article about the study in PT in Motion: “Patients with [lower back pain] who received care from a PT first experienced lower out-of-pocket, pharmacy and outpatient costs after 1 year and reduced their likelihood of receiving an opioid prescription by 87% compared with patients who never visited a PT. The PT-first group also was associated with a 28% lower probability of having imaging services and 15% lower odds of making a visit to an emergency department.”  

It can be used for a variety of injuries and diseases. There are many pain-causing conditions that could benefit from PT—from aging-related conditions to back pain to fibromyalgia, headaches, rheumatoid arthritis and neuropathic pain syndromes such as complex regional pain syndrome (CRPS) or reflex sympathetic dystrophy, says Gilbert. “CRPS is a pain syndrome that can develop after an injury, a stroke or heart attack, or a surgery. Typically affecting an arm or a leg, the level of pain tends to be out of proportion to the severity of the original injury,” he explains. “Swelling, hypersensitivity, joint stiffness, changes in skin texture and hair growth can occur in many cases. CRPS can be extremely debilitating and lead to depression and other problems. Physical therapists can provide gentle manual therapy techniques, therapeutic exercise and various heat and cold modalities to reduce pain levels while building strength and conditioning.”

Treatment options vary. “Physical therapists are trained to treat patients as the individuals they are. Therapists can get advanced training in manual techniques that have been shown to help reduce pain (Myofascial release is an example),” says Gilbert. “Sessions would include hands-on techniques to reduce pain and swelling, improve range of motion, and reduce their sensitivity to movement overall.” Other options? PTs may include massage, cold laser therapy and electronic stimulation in their treatments, among others. “After the pain levels improve, the PT can begin progressing their exercise program and activities, all the while listening to the patient’s feedback, and carefully monitoring their response to each treatment.”

And treatments are always evolving. “The treatment of pain has evolved over recent years to more involve the individual patient’s mental health and unique life history,” explains Gilbert. “’Re-wiring the brain to ease chronic pain’ involves navigating a variety of factors – physiological and psychological. Physical therapists have been involved in new approaches and initiatives for people who’ve struggled with pain for years, after medications and surgeries have failed. These novel approaches include education, deep breathing and body awareness, along with other ways to change how patients deal with their pain.”

Things might be slow-going—and talking to your therapist is key. It’s important to know that results might not happen overnight. “Treating chronic pain can be a long and slow process, and the physical therapist needs to work with their patients to keep them motivated and engaged toward achieving their goals,” says Gilbert. Plus, what works for others might not work for you—and it’s important to go easy on yourself. “Be patient with your progress, and set small achievable goals for yourself, rather than expecting 100% pain relief the first few sessions. You and your PT are a team, so communicate with your PT regularly and do your best to attend all sessions!”

Learn more about physical therapy at Burke.

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Burke's Rehab Insights blog is intended to provide general information about rehabilitation and other health care topics. It should not take the place of medical care. Burke staff cannot comment on individual medical cases or give medical advice.

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