Navigating Pain: A Physiotherapist's Guide to Understanding Chronic Pain
As physiotherapist’s, we encounter countless clients struggling to grapple with pain (no one comes to physio when they feel 100% after all!)
Read on to hear how we, as Physiotherapists, teach clients to understand their own chronic pain in a way to make their pain management journey more beneficial!
As physiotherapist’s, we encounter countless clients struggling to grapple with pain (no one comes to physio when they feel 100% after all!)
It's not just a physical sensation; it's a complex interplay of biological, psychological, and social factors. One of the greatest challenges in treating chronic pain is helping clients to understand that pain doesn't always equal harm. In fact, understanding this concept is crucial for effective pain management.
Pain is a mechanism made by the body for survival. For example, walking barefoot across a field of three corner jacks sends feedback to your brain to say “stop doing this” as it is damaging. Makes sense, right? Unfortunately, in the case of chronic pain, this feedback to the brain has changed. This means that while structurally there is no damage, or you are not doing anything harmful, your body can register pain.
The pain is real, just as much as someone cutting your arm with a knife - but the reason why this is happening is that the brain is being ‘over protective’. A great analogy is to imagine your body as a car with a sensitive alarm system. When a car alarm goes off, it usually means that there's a thief trying to break in, so we trust the alarm.
In chronic pain, a butterfly or gust of wind may set off the car alarm - even though it isn’t anything harmful to the car. That’s why some people can report lower back pain while brushing their teeth; a stimulus like this shouldn't set the car alarm off. Similarly, when you experience pain, it doesn't necessarily mean that there's significant tissue damage or harm occurring. The key message of this is that while pain is your body's way of alerting you to potential danger, it's not always an accurate indicator of tissue damage.
This is where the "hurt not harm" principle comes into play. It's essential for you as someone in pain to distinguish between pain that signifies actual tissue damage (harm) and pain that is merely a protective response (hurt). Understanding this principle can help alleviate the fear and anxiety that often accompanies chronic pain. It allows people to reframe their perception of pain and empowers them to take control of their pain management journey. It will also assist clients in understanding why physiotherapists are prescribing you exercises when you are in pain.
While your physiotherapist will be able to discuss these concepts in more detail and specific to your concern,, here are some common suggestions we make in the clinic:
Education: Knowledge is power. Take the time to educate yourself about pain physiology and the factors that influence your pain experience. Understanding how pain works can demystify the experience and reduce anxiety.
Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing, and progressive muscle relaxation can help you manage pain by promoting relaxation and reducing stress.
Graded Exposure: Just as you wouldn't expect to run a marathon without training, you shouldn't expect your body to jump straight into activities that exacerbate your pain. Gradually expose yourself to activities that you find challenging, pacing yourself and listening to your body along the way.
Physical Activity and Exercise: Contrary to what you might think, staying active is often beneficial for chronic pain management. Low-impact exercises such as walking, swimming, or yoga can improve flexibility, strength, and overall well-being.
Pain Coping Strategies: Develop a toolbox of pain coping strategies that work for you. This might include distraction techniques, positive self-talk, or using heat or cold therapy.
Seeking Support: Don't hesitate to reach out for support from healthcare professionals, support groups, or loved ones. Chronic pain can be isolating, but you don't have to navigate it alone.
Remember, managing chronic pain is often a journey of trial and error. What works for one person may not work for another, so it's essential to be patient and persistent in finding the strategies that resonate with you. By embracing the "hurt not harm" principle and adopting proactive pain management strategies, you can take significant steps towards reclaiming your life from chronic pain.
As a physiotherapists, our goal is not just to treat your symptoms, but to empower you to become an active participant in your own healing journey. Together, we can work towards a future where pain no longer dictates your life, but rather serves as a signal for growth and resilience.
Written by Kara Ballard, Physiotherapist
Fleurieu Coast Physio
Great resources:
Book: Explain Pain Second Edition. David S. Butler & G. Lorimer Moseley
Book: Pain is Really Strange Paperback by Steve Haines and Sophie Standing
