Reducing Pain Through Physical Therapy

There isn’t a cure for chronic pain, so many times, patients will turn to medications for chronic pain relief, such as over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids. 

But more conservative treatments such as physical therapy can help without being tied to as many side effects as medications – long-term NSAID use can cause gastrointestinal problems and prescription painkillers have addictive properties. Learn more about the benefits of physical therapy in treating common long-term orthopedic issues.

What is chronic pain?

Your body has many receptor nerve cells that send messages to the brain via the spinal cord that signals pain.

Chronic pain is a type of pain that continues even after the injury or illness that caused it has resolved. Chronic pain may be persistent all the time or it may come and go throughout the day or week. Symptoms can vary, but chronic pain may feel like aching, burning, shooting or throbbing pain. Learn more about how to talk to your doctor about pain.

It’s important to understand the difference between chronic pain and recurrent pain. While recurrent pain involves repeated episodes of discomfort, chronic pain persists beyond the expected healing time of an injury or illness. Newer research is emphasizing the emotional and psychosocial components contributing to pain. In other words, the nervous system becomes more reactive or sensitive to pain.  

Chronic pain can be the result of an acute injury, such as a herniated disc in your back, that has lasting effects and causes long-term issues. In other cases, chronic pain may develop without an injury. Instead, overuse, instability or weakness is the culprit.

In the U.S., millions of adults suffer from chronic pain. According to a survey from the National Center for Complementary and Integrative Health, 20 percent of people had chronic pain. An additional 7 percent of adults had chronic pain that limited their life or work activities. People who deal with chronic pain may suffer from lost wages, lost productivity or mental health issues.

Among the types of chronic pain, arthritis impacts more than 50 million Americans. Chronic back pain is also common, with 16 million people living with persistent pain. 

Benefits of physical therapy

In terms of low-cost, low-risk treatment options, physical therapy offers many benefits when it comes to treating chronic pain.

Determine the cause of pain: Physical therapists employ various methods, including physical exam and medical history, to form hypotheses about the potential causes of your pain and develop tailored treatment plans to address the underlying issues. Reduces pain: Unlike ice, heat and other sources of short-term pain relief, physical therapy’s ultimate goal is to reduce pain over time. In other words, masking the pain with medications or prescriptions may trick your brain into thinking the pain is gone, but physical therapy helps treat the root of the problem.

Reduces inflammation: As part of a natural response to pain, the body initiates an inflammatory response to heal. Chronic inflammation is present when pain becomes a part of your everyday life. Physical therapy can help reduce this inflammation and, in turn, reduce pain and swelling in the affected area.

Increases flexibility: Some people who are chronically inactive have tense, tight muscles that can benefit from physical therapy. More flexibility creates less tension on muscles, tendons, ligaments and joints that all can cause pain.

Improves strength: Instability is a common cause of chronic pain, and strengthening areas of the body to better support the injured area can go a long way in providing symptomatic relief. For example, strong muscles around a deteriorating joint that provide stability during routine movements such as walking or bending over.

Types of physical therapy

Physical therapists use two types of treatment modalities for pain: active and passive physical therapy.

Passive physical therapy

Most people are familiar with this type of therapy, as it involves patients receiving the treatment compared to doing it themselves. These techniques are performed by a physical therapist or a technician. 

“Physical therapy offers a comprehensive approach to managing chronic pain by addressing the root causes rather than just masking the symptoms. Through targeted exercises and manual therapy, we aim to reduce inflammation, improve strength and flexibility and ultimately enhance the patient’s quality of life,” says Charles Steger, PT, DPT, COMT, a rehab physical therapist at INTEGRIS Health Jim Thorpe Rehabilitation.

Examples include:

• Manual therapy techniques or joint mobilization techniques
• Patient education
• Dry needling
• Heat and ice
• Massage
• Electrical stimulation
• Ultrasound

Active physical therapy

By contrast, active therapy involves you, the patient, initiating your own movements. These exercises help strengthen muscles and improve range of motion. A physical therapist will skillfully guide you in activities designed to help reduce your pain and increase your function.

Examples include:

• Resistance exercises
• Strengthening exercises
• Stretching
• Low-impact aerobic exercise
• Postural correction
• Activity modification

A combination of active and passive physical therapy is usually the most beneficial to the patient. For example, if you have back pain, ice, heat and massage may temporarily make your back feel better. But the root of the problem is likely not being addressed. A physical therapist can teach you how to mix in active components via movements, postures, exercises and activity modification to address the underlying issues.

What can physical therapy treat?

Physical therapy can work on just about any type of ailment, from pain caused by headaches down to foot pain from structural imbalances.

Back pain

Chronic back pain often doesn’t have a clear cause. It may be because of chronic overuse, poor posture over time or even genetics that make it harder for the spine to support your body weight and certain movements. 

Still, there are ways to use physical therapy to provide symptomatic relief. Since your core plays such a strong role in back support – these muscles support and stabilize the spine and help maintain balance – strengthening this area helps. Ultimately, a physical therapist will help determine the cause and map out ways to address the back pain.

A physical therapist can also help you retrain your posture, increase your flexibility, aid in stretching secondary muscles that can improve back pain and discuss aerobic exercises to incorporate into your routine.

Knee pain

Chronic knee pain is one of the most common types of issues people deal with as they age – it explains why more than a half-million people need knee replacements each year. Arthritis, tendonitis and knee injuries (ACL tears, torn cartilage) are among the top reasons why people have nagging, long-term knee pain. 

The goal of physical therapy is to determine the cause of knee pain and ensure the knee is moving the way it needs to. By using body mechanics, you then learn to retrain muscle control and strengthen the muscles around the knee so it can absorb more wear and tear. Target areas include the quadriceps, hamstrings, abductors and glutes. It’s also important to maintain flexibility to avoid stiffness and soreness.

Hip pain

Chronic hip pain can be caused by various types of issues, stemming from arthritis, bursitis or structural conditions. Perceived hip pain is commonly due to issues with the back. In addition, rheumatoid arthritis is a common source of hip pain.

Physical therapy not only targets the hip itself, but it also works to increase joint mobility and movement patterns in the buttocks, hamstrings, piriformis and abductors.

Depending on the area of pain, your physical therapist may use manual therapy or work with you to improve flexibility in that area. Manual therapy is an integral part of addressing all musculoskeletal pain. Gait training and balance training can also improve symptoms.

Shoulder pain

Movement of the shoulder is a complex coordinated system that requires synchronized control of many muscles and joints. There are three true joints associated with the shoulder (glenohumeral joint, acromioclavicular joint and sternoclavicular joint) and a pseudo-joint (scapulothoracic joint). Impairments in the coordination of the shoulder or specific injuries can lead to tendon inflammation or instability. 

Physical therapy for shoulder pain typically involves stretching, strengthening and joint mobilization/stabilization (postural correction).

The INTEGRIS Health Jim Thorpe Rehabilitation Center has an outpatient rehabilitation center specifically dedicated to orthopedics. Whether you have neck and back pain or nagging knee pain, the team at Jim Thorpe can help you restore function, increase range of motion and help with the pain.