As Physiotherapists we deal with pain on a daily basis. It is the number 1 reason why people seek treatment from us. Pain is our Brain’s interpretation of threat detected by our nervous system. Our response and experience of pain is very individual and is heavily influenced by numerous factors such as the type and site of tissue injured, our environment, stress, thoughts of harm created by movement during the healing process, work pressures and these are to name but a few.
Pain we experience from the musculoskeletal system will generally start with detection of an altered state by our nervous system – whether this is from muscle, nerve, bone, connective tissues etc. However the experience we have is dependent on the threat level that our brain awards this altered state.
In the acute phase of healing (i.e. the first six weeks) pain has a purpose. It is our bodies way of helping us reduce injury and help injured tissue to recover. In the majority of patients, as the injury recovers, our nervous system reduces the threat level and allows us to move normally. We call this in medicine ‘decending inhibition’ – think of it as our nervous systems ‘off valve’.
However in some patients, the threat ‘awarded’ to the injury by the brain continues, even when the tissue is known to have recovered. This state is commonly observed in patients with chronic pain. In this state, the nervous system becomes more sensitive and may start perceiving normal day-to-day activities as threatening. Unlike conditions such as Rheumatoid Arthritis and diabetes, which have clear treatment and management guidelines, treatment of chronic persistent pain requires expert knowledge of how the condition affects each individual so a treatment plan can be tailor made for you.
At Performance Physiotherapy, we have the skills to help you move more effectively, with greater confidence and less pain. We can work with you to develop well rounded coping strategies and empower you to help reduce pain and improve function. Some of the strategies we may use are:
- Motor control retraining – exercise to improve control of movement.
- Graded exercise and pacing – to teach you ways of managing.
- Mirror Box Therapy.
- Graded Motor Imagery.
- Manual therapy.
- Biopsychosocial approaches.
We may also liaise with pain specialist consultants in pain management to utilise apprpriate and agreed medical treatment to help improve your response to treatment.