Why Do I Have Pain?

Article by Remi Lu,
Registered Physiotherapist, 
Body Works Sports Physiotherapy, 
July 2 2020

Chronic pain is a condition that affects numerous Canadians from all walks of life. According to an article from The Journal of the Canadian Pain Society, around seven million Canadians of all ages experience chronic pain that interferes with their work life and activities of daily living.

While many people turn to pharmaceutical medications to manage their pain, recent evidence shows that non-pharmacological therapy should be the first line of management for the chronic pain population. Physiotherapy can hopefully help you!

However, it can be difficult to find a healthcare practitioner to work with you to manage your care. Many patients express frustration that they feel unsupported and dismissed by their health professionals, with many of them expressing frustration that their care providers see their body as a set of problems to be solved with a prescriptive, impersonal approach.

Chronic pain is real, and it is personal to you and your situation. With a personalized treatment plan by a trained professional, physiotherapy is a crucial step in the recovery from chronic pain. 

What Is Chronic Pain?

Chronic pain is characterized by pain that persists beyond a normal time of healing, and/or pain that persists for longer than 3-6 months. While the condition can present itself following an initial injury, oftentimes the pain cannot be solely explained by anatomical damage. This means that for many patients, medical imaging can often come up clear.

Even in the absence of tissue injury however, real physiological changes can occur. In patients with chronic pain, the nervous system can become overprotective and amplify neural signalling. This means that everyday tasks such as sleep, getting out of bed, walking, and sitting, can be very painful. In addition, environmental stimuli may further amplify the pain. 

Physiotherapy Assessment for Chronic Pain

The goal of the assessment process with your physiotherapist will be for her or him to understand your medical history, including information specific to your pain history and how your pain experience has affected your life and current functioning.

This may involve questions such as:

  • How is pain affecting your life?
  • How do you cope with your pain?
  • Have you been feeling anxious/worried/depressed?
  • How do people respond when you have pain?

During the session, your physiotherapist will also perform a physical assessment to gather information to develop a treatment plan specific to you and your abilities.

Physiotherapy Treatment for Chronic Pain

The role of the physiotherapist in the management of chronic pain is to use their professional training as a movement expert to work within the framework of your presentation to help you work towards pain-free movement.

Your physiotherapist will work with you to develop an individualized treatment plan based on the factors specific to you. This may include a combination of:

  • Pain neuroscience education: This is a process that will begin at your first session and continue throughout your treatment. It will improve your understanding of the pain process and how your environmental context may influence your pain response. In addition, your physiotherapist will explain how active treatment strategies promote recovery and improve physical activity and function. 
  • Graded activity and exercise: Appropriate exercise prescription is an important part of optimizing function and mobility in people with chronic pain. A graded approach to activity and exercise can help gradualize reintroduce pain-free activities to your life. Based on your tolerance to the movement, your physiotherapist will work with you to find an activity range that will allow for flexibility based on how you feel that day. Your physiotherapist’s goal will be to find an activity level that you are comfortable with and will still help you work towards your goals. 
  • Relaxation and mindfulness: Techniques such as mindfulness and breathing for relaxation can be incorporated as a key part of the management plan for people with chronic pain. These techniques is can also help to calm your sympathetic nervous system response. Your physiotherapist may incorporate activities such as progressive muscle relaxation, yoga, meditation, and deep breathing into your treatment plan.
  • Sleep management: Sleep disturbance can be a common presentation for those presenting with chronic pain. Please let your physiotherapist know if you are having troubles with sleep. Your physiotherapist may discuss sleep management techniques for you such as keeping a sleep diary, promoting good sleep hygiene, or may collaborate with another healthcare professional to provide appropriate sleep management for you.  

Remember to ask your physiotherapist questions throughout the entire assessment and treatment process. 

Book With Body Works Sports Physiotherapy

Here at Body Works Sports Physiotherapy our goal is to work with you to manage your pain and get back to doing the activities that you love. Our trained physiotherapists will work with you to understand your complete presentation and use an individualized, flexible approach to the management of your care. 

We understand how frustrating it can be to have your pain experiences dismissed and live with your pain without finding a solution. Our registered physiotherapists are here to listen and use our skills to provide a safe and supportive therapeutic space to help you work towards your goals.