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Scott Dehorty MSW, LCSW-C

Chronic Pain

The Role of Physical Therapy in Treating Chronic Pain

Trust and a commitment to slow and steady progress are essential to success

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I work with a team of experts to deliver an integrated treatment program for those suffering with chronic pain. Our diverse group includes counselors, physicians, nurses, physical therapists and certified personal trainers. We also have staff who specialize in aqua therapy, acupuncture, massage, reflexology, yoga and art therapy. Today I’d like to focus on the power of physical therapy in treating chronic pain syndrome.

In talking with our lead physical therapist I was reminded of the unique role physical therapy plays in treating chronic pain. Patients who have experienced extended periods of chronic pain are typically unable to maintain a healthy lifestyle or achieve a state of general fitness. As a result, they are often more susceptible to injury because of weakened joints and tissues. Patients with extreme forms of chronic pain are often unable to tolerate even the lightest touch, even in areas that are not directly associated with the primary sensations of pain.

In such cases, the physical therapist must first interact with the patient to achieve a level of trust and belief: A belief that physical therapy will yield positive results, that a reduction or lessening of the pain is achievable, and that there will be progress – albeit slow and steady. Chronic pain that has been present for years may take significant time before noticeable improvements are realized. Small successes should be celebrated and built on to achieve a longer-term positive outcome.

A patient with hypersensitivity to touch often requires gentle, hands-on treatment to determine levels of sensitivity and to establish trust and confidence. Light massage, stretching and perhaps gentle traction can be effective in treating pain along the spinal column. If the patient tolerates this well, additional modalities may be introduced, including moist heat, hydrotherapy, therapeutic ice, electrical stimulation and ultrasound. Each of these can relieve pain, reduce inflammation and edema, and relax tense and spasmodic muscles.

Once the patient is comfortable with these stimuli, a low-intensity exercise program may be introduced. If pain persists at high levels, a focus on exercising a non-painful area may work best at the outset. For example, patients with shoulder pain might do well with exercises for strengthening the core. If back pain is the issue, lower extremity exercises can be effective. The idea is to get the patient comfortable with establishing a routine and then gradually increase the exercises in intensity and, eventually, focused on the painful areas themselves.

Chronic pain patients are often caught in a cycle of pain avoidance, which leads to inactivity. This creates an unhealthy lifestyle, which in turn reduces strength, endurance, range of motion and overall confidence. Patients become more susceptible to injury and unable to work through the healing process. And so the cycle continues.

When the patient begins to believe that freedom from pain is possible, and that a healthy lifestyle, routine exercise, and proper nutrition leading to overall fitness will help maintain that freedom, they will develop the confidence they need to incorporate these elements into their daily lives.

How has physical therapy helped you with dealing with chronic pain?

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About the Author

Scott Dehorty, MSW, LCSW-C, is a pain recovery specialist in The Pain Recovery Program at Father Martin’s Ashley treatment center.

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