Table of Contents
- Addressing Chronic Pain with Physical Therapy
- When Physical Therapist May Help
- Types of Physical Therapy
- Physical Therapy Tools and Equipment
- When to Refer for Physical Therapy
The U.S. Pain Foundation says 50 million people experience pain every day. The Centers for Disease Control National Health Interview Survey found that 20.4 percent of adults live with chronic pain, and 7.5 percent experience pain severe enough that it frequently interferes with work or life activities. Physical therapy is an effective treatment that can help reduce pain by targeting the specific area of the body that is the source of pain.
Addressing Chronic Pain with Physical Therapy
Millions of people suffering from chronic pain end up taking opioid medications and quickly become addicted. The National Institute on Drug Abuse reports that 21-29 percent of patients misuse opioids prescribed for chronic pain. Opioid prescriptions can be helpful when not misused, but they are not a permanent solution. In fact, drugs mask pain sensations and do not treat the cause of pain.
An alternative for long-term pain management is physical therapy or physiotherapy for pain. Physiotherapy is a type of physical therapy that uses mostly manual therapy to treat conditions and injuries impacting movement. Physical therapy is a rehabilitative health treatment that uses a variety of methods, instead of drugs, for pain relief.
The purpose of physical therapy is to:
- Reduce feelings of pain
- Strengthen muscles, tendons, and ligaments
- Restore balance when imbalances are present
- Improve the range of motion
- Address issues like scar tissue
- Improve general functioning
Pain can develop for many reasons, primarily due to injury and disease. The physical therapist uses special equipment and specialized exercises and techniques to improve the quality of a patient’s life.
When Physical Therapist May Help
A doctor will know when to refer to physical therapy for pain management. The therapist does not replace a doctor. The professional provides customized supplemental treatment for pain due to conditions like the following.
- Lower back pain
- Shoulder pain
- Neck pain
- Bursitis or tendonitis
- Foot and ankle dysfunction
- Lumbar stabilization
- Muscle strains
- Post-surgical rehabilitation
- Carpal Tunnel Syndrome
- Herniated discs
- Leg pain
- Rotator cuff injuries
- Sciatica pain
- Overuse injuries
- Tennis/Golfer elbow
- Nerve injuries
- Sports injuries
- Diseases like Parkinson’s disease and Multiple Sclerosis
In fact, most conditions causing pain and limited movement can benefit from physical therapy.
Types of Physical Therapy
There are different kinds of physical therapy (PT), but the physical therapy pain management techniques are broadly classified as passive PT or active PT.
Passive physical therapy treatments involve the patient being still while treatments are applied and effective to help with immediate pain relief. Active physical therapy requires patient participation and may help a patient for longer time periods.
Studies have shown that both types of physical therapy treatments can be effective, and integrating both in a treatment plan can be especially successful in treating certain conditions like arthritis, low back pain, and neck pain.
Passive physical therapy treatments
Some of the most common passive physical therapy treatments include the following.
- Application of heat, cold, or both
Using heat or ice packs or alternating each can reduce inflammation and muscle spasms
- Transcutaneous electrical nerve stimulator (TENS)
The TENS unit uses electrical stimulation to reduce the sensation of pain by overriding the pain signals sent to the brain. The electrical pulses are sent to the sensory nerves underneath the skin.
The steroid is placed on the skin, and an electrical current is applied. The current leads force the steroid under the skin where it can reduce inflammation and pain.
- Laser therapy
Photons of laser energy penetrate under the skin to reduce painful inflammation and help speed up tissue healing.
A cold gel is placed on the skin. Sound waves from an ultrasound machine are then applied to the gel location. The waves penetrate the soft tissues.
- Massage therapy – A massage can help to relax muscles and other soft tissues.
Active physical therapy treatments
Active physical therapy treatments have the patient participate in the treatments while the physical therapist provides guidance and assistance.
- Range-of-motion exercises
People who have a stroke, experience an injury or have a long stay in bed can benefit from range-of-motion exercises. The physical therapist assists with moving the limb at a greater range of motion and beyond the point of pain at each session.
- Dynamic lumbar stabilization
The focus of this treatment is stretching to relieve back and neck pain. The stretches reduce muscle tension and improve the range of motion. They include exercises like the back flexion stretch and knee to chest stretch.
- McKenzie approach
The physical therapist assists the person with doing exercises that extend the spine and reduce pain. It focuses on centralizing pain away from the leg or arm and to the back where the pain is more tolerated.
- Aquatic exercise
Aquatic exercise is conducted in a pool. Pressure on the spine is relieved by the buoyancy of the water. The patient can work the muscles while experiencing less pain than would normally be felt, especially in cases of severe shoulder, neck or back pain.
- Targeted and general conditioning
The physical therapy exercises can focus on a particular area of the body, i.e. lower back, neck, joints, inflamed area, etc. A patient with a total body medical condition like fibromyalgia could benefit from general conditioning physical therapy. There are strengthening, stretching, aerobic and endurance exercises.
These are a few of the active treatments. Physical therapists have a wide range of treatment options, enabling them to match the treatment plan to the patient’s specific needs.
Physical Therapy Tools and Equipment
Physical therapists use a variety of equipment in active physical therapy treatments. The physical therapy tools used in therapy include the following.
- Items like ankle weights and weighted handballs
- Recumbent bicycles
- Resistance bands
- Title tables
- Exercise balls
- Treatment tables
- Pilates reformer
- Exercise bikes
- Kaiser functional trainer for pneumatic resistance
- TRX for suspension training
- Range of motion measurement instruments
- Muscle testing instruments
This is just a sample of the physical therapy tools and equipment.
When to Refer for Physical Therapy
When looking for pain relief and physical therapy is recommended by your doctor, the physical therapist has a wide range of treatment options. Physical therapy for pain reduction is usually suggested when chronic pain develops or when pain accompanies the loss of mobility and function due to an event like a stroke or auto accident. The physical therapist will work closely with the patient to deliver passive and/or active treatments and will instruct the patient on the best techniques for exercising at home.