Physical Therapy Guide to Pain

Once your condition has been diagnosed, your physical therapist will work with you to develop a treatment plan to help address your pain.

Treatment for Acute Pain

If you have acute pain, your physical therapist will help identify the injured tissue (eg, bone, muscle, tendon) and devise treatments to help promote healing and reduce stress on the injured area.

Your physical therapist will offer guidance as to how to safely return to your normal activities without further damaging the injured tissue. Research demonstrates that people who return to their normal daily activities more quickly following injury recover faster and have fewer long-term problems than people who do not return to activity in a timely manner.

Your physical therapist may help you identify positions that hurt and positions that do not hurt, and provide treatment and exercises to help the injured tissue move more efficiently. Physical therapists are movement experts.

Treatment for Chronic Pain

If you have chronic pain, your physical therapist can help you identify factors that may be leading to the prolonged pain. These factors may include faulty movement patterns, muscle weakness, areas of stiffness that prevent normal motion, previous injury and past events that may be contributing to your pain, fear, negative emotions, and other behaviors or social factors that can lead to long-term pain.

Your physical therapist will design a treatment program to fit your specific needs, which may include manual (hands-on) therapy, and gentle exercises to relieve pain.

Your treatment may emphasize education about the latest findings regarding pain, in addition to healing exercises and manual therapy. Research has demonstrated that positive changes occur in the brain after patients are educated about the purpose and causes of pain.

Treatment Techniques

Because the mechanisms of pain vary, each approach to care will also vary. Treatments are likely to include a combination of the following, depending on your unique needs:

Manual therapy. Manual therapy consists of specific, hands-on techniques that may be used to manipulate or mobilize joints and muscles. Manual therapy is often used in conjunction with other activities to increase movement, and has been shown to reduce pain. Some physical therapists have additional certifications that identify them as having advanced training in this type of therapy.

Movement and exercise. Moving more and exercising can often be a great strategy to lessen pain. Studies have found that those who exercise on a regular basis experience less pain. Your physical therapist will help identify specific movements that will help reduce your symptoms.

Modalities. Your physical therapist will be able to determine whether the use of modalities such as ice, heat, or electrical stimulation applied to specific areas will benefit your unique condition.

Graded exposure. Because emotions such as fear are often associated with pain, your physical therapist may slowly introduce movement and activity back into your life. Graded exposure may involve visualizing movement followed by slowly and safely beginning to move in ways that are pain free, to start the process of returning to normal activities. This type of approach has been shown to help reduce pain and restore the ability to perform everyday activities.

Psychologically informed physical therapy. Research consistently demonstrates that pain is closely tied to, and is influenced by, psychological factors such as fear, anxiety, and depression. Addressing these factors has been shown to help reduce the amount of pain a person is experiencing. If you have chronic pain, your physical therapist will work with you to address factors like these that may be contributing to your pain.

Home program. Your physical therapist will help you develop a home program that is individualized to your specific needs and requirements. Research shows that the positive relationship between you and your physical therapist, focused on your well-being, is an important factor in your recovery process.