How physical therapists treat pain

Treating chronic pain with physical therapy techniques

Stuart Eivers, DPT, OSCBy Stuart Eivers, MTI Physical Therapist

Physical therapists are uniquely trained to treat a multitude of painful conditions. For many years, the profession has focused on movement and function—orienting treatment toward those goals and away from pain. However, with the advent of advances in neuroscience research, physical therapists are now better equipped to treat painful conditions, including chronic pain.

Pain has been defined by the IASP (International Association for the Study of Pain) as: “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” This means that pain is an output not an input. It is an emotional reaction to noxious stimuli (nociception). This is a very important concept to understanding pain and our reactions to it.

Chronic pain is a condition lasting longer than three months. If a painful condition (back pain, a sore knee, etc.) lasts longer than this period of time, the brain processes the painful experience in different areas of the brain than acute pain. These areas are more associated with our limbic system, thus influenced more by our emotional being. If we are stressed from work, worried about money, or surviving a pandemic, these factors can influence our pain experience. In some instances, chronic pain can become a condition in and of itself, and traditional medical interventions will not help and can sometimes make the condition worse.

The first thing a physical therapist will do in treating chronic pain is educate you on what is really going on. One session of Pain Neuroscience Education (PNE) can reduce the painful experience by up to 30 percent. Once you understand your condition and how much power you have in the situation, you can start to map your pathway to overcoming it.

One program that has been used to successfully treat patients with chronic pain is Dr. David Hanscom’s Direct Your Own Care program (DOC). The idea is to use education to provide you with more awareness of your condition and your response to it, which can then allow you to separate yourself from your symptoms so that they do not define who you are.

The first thing a physical therapist will do is give you a comprehensive evaluation of your condition. In subsequent therapy sessions, you will be given tools such as diaphragmatic breathing, meditation, guided imagery, relaxation techniques, and advice on posture. These techniques will train your nervous system—specifically the parasympathetic system—to learn how to adapt to stress (including pain) in a more functional way. Manual therapy and therapeutic exercise will also be employed to address your specific functional challenges in a progressive program to reach your goals. All the while, the therapist will employ motivational interviewing, active listening, and reframing to help you better understand your condition and its effect on your body.

The WAC’s mission is to enrich the quality of life of its members. One way that we are committed to that is by providing access to healthcare—including physical therapy—that allows you to live your life fully and pain free!

—Stuart Eivers is a physical therapist with MTI Physical Therapy at the WAC, located on the 4th Floor of the Clubhouse in the WAC Wellness Center. WAC members may schedule an appointment with Stuart by calling 206.839.4780 or emailing MTI is in-network with most major health insurance companies.


—Posted July 27, 2022

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