Chronic pain conditions

Chronic pain has been defined as pain lasting longer than 3 to 6 months and occurs in addition to the pain of the original health condition. It is pain that has become independent of the underlying illness or injury that first caused pain to begin. It is not a long-lasting version of an acute pain and it becomes severely debilitating.

It occurs when the nervous system remains hypervigilant beyond that needed as an appropriate response to the acute injury and the time needed to heal. It becomes more reactive to stimulus of any sort (known as ‘hypersensitivity’) causing a process called ‘central sensitisation’. This results in pain becoming widespread, rather than localized, and increasingly intense, with sometimes even normal touch hurting. This then becomes a vicious cycle that carries on worsening unless interrupted. In addition to this, there is often a secondary effect on our emotional state with increased anxiety, irritability, poor sleep (which itself is damaging), fatigue and depression.

Not all pain is curable, but all pain is treatable.

Physiotherapy is one of the approaches advocated by the NHS to treat chronic pain.

Approaches used in physiotherapy are:

1. Exercise – graded, and often low impact, with focus on pacing, endurance, and flexibility.
2. Looking at the work environment to assist the sufferer to stay in work, alongside our colleagues in Occupational Therapy.
3. Gentle soft tissue techniques to improve balance of tension within the body.
4. Advice around posture and how to move efficiently to reduce the pain and its impact.
5. Teaching relaxation and distraction techniques.
6. Referral to specialist centres – for example pain and sleep clinics, pain support groups and psychology.

Benefits of physiotherapy are: