Chronic Pain

7 Reasons To Use Physical Therapy For Chronic Pain

If you haven’t tried physical therapy before, you may wonder how it could help relieve your chronic pain.

A physical therapist can show you how to perform exercises to will help ease chronic pain.

Physical therapy uses a variety of approaches to tackle pain/chronic pain and boost physical functioning, and is often recommended as part of pain management.

What Physical Therapy Offers
These are seven ways physical therapy can help with chronic pain:

1. Individualized treatment. Physical therapy is all about you. You and the therapist will go over the various aspects of your pain the first time you meet. If you’re anxious about some aspect of physical therapy, this is the time to bring it up. It’s also a great time to bring up any specific goals you have. Maybe you’d like to walk longer distances or ride your bike again, for instance. The more open you can be about problem areas and goals, the better. Once you’ve reviewed everything, the therapist will develop a program tailored specifically to your needs.

2. Safe moves. It’s natural to be cautious in your movement when you’re hurting, but physical activity is needed to decrease stiffness, ease pain, and enhance your overall functional ability. Having a physical therapist direct and monitor your movements will dispel your worries about injuring yourself, allowing you to safely push yourself beyond what you could do independently.

3. An opportunity to avoid surgery. Physical therapy is a nonsurgical treatment often recommended to patients before considering surgery. The combination of manual therapies, specific functional strengthening exercise, stretches, and modalities can often relieve pain and improve functional ability so well that surgery is avoided.

4. Hands-on pain relief. Manual therapy is often used in skilled physical therapy– it involves pressure applied to targeted areas of the body to improve tissue extensibility; increase range of motion, and mobilize soft tissue and joints in effort to reduce pain.

5. Strategies to ease pain. Physical therapists are often a good resource to help you understand physiological factors and neuroscience involved in your pain. They are also able to suggest some ergonomic tweaks to your workstation and/or explain how tobacco use or alcohol could make your pain worse.

6. Support and encouragement. Working closely with someone focused on relieving your pain can offer both a physical and mental boost. Chronic pain can be an isolating experience, and it’s nice to know you’re not alone.

7. Control over your pain. Knowing that there is a way to reduce and manage your pain on your own, without medicines or surgery, can give you a sense of control. That sense of control can ease the release of stress hormones, further reducing pain.

Physical therapy sessions generally run from about 20 minutes to an hour, and usually include more than one visit per week. Over time, most people learn exercises and stretches to perform independently at home, and formal physical therapy appointments are no longer needed.

Physical Therapy offers a non-drug alternative to Pain Management

NIH Says Current Treatment of Chronic Pain Has Created ‘Silent Epidemic;’ More Focus Needed on Non-Drug Approaches

News Now Staff – APTA

According to a report recently released by the National Institutes of Health (NIH), it’s time that treatment of chronic pain moves from a 1-pill-fits-all mindset to an evidence-based, individualized, multidisciplinary model that recognizes the value of non-pharmacological approaches, including physical therapy.

The report (.pdf) is the product of an NIH panel that looked at the current state of treatment for chronic pain, which is estimated to affect 100 Americans. In addition to looking into research on the issue, the panel convened a workshop that included more than 20 speakers. The results of the panel’s work were published earlier this week (.pdf), and featured in the online edition of Time magazine.

Much of the report is focused on the use—and possible overuse—of opioids as the “go-to” approach in almost all cases of chronic pain. In addition to contributing to patterns of drug abuse, the reliance on opioids may simply not be helping in all circumstances, according to the panel report.

“Together, the prevalence of chronic pain and the increasing use of opioids have created a ‘silent epidemic’ of distress, disability, and danger to a large percentage of Americans,” authors write. “The overriding question is whether we, as a nation, are currently approaching chronic pain in the best possible manner that maximizes effectiveness and minimizes harm.”

The answer to that question, the panel found, is no. Patients with chronic pain are typically “‘lumped’ into a single category, and treatment approaches have been generalized with little evidence to support this practice,” they write.

Because the manifestations and response to pain can be so varied, the report calls for a variety of treatment options that include physical therapy, which is specifically mentioned in the report. These non-pharmacological treatments can be very effective—the problem, as one speaker at the workshop noted, is that “lack of knowledge or limited availability of these non-pharmacological modalities and the ready availability of pharmacological options and associated reimbursement structure appear to steer clinicians toward the use of … opioids.”

An NIH press release on the report quotes panel chair David B. Reuben, MD, as saying that “clearly there are patients for whom opioids are the best treatment for their chronic pain. However, for others, there are likely to be more effective approaches.” The solution, he believes, is to ensure that “every patient’s individual needs are met by a patient-centered health care system.”

The panel report cites many barriers to the implementation of such a system, including lack of substantive evidence-based research, limited physician access to experts in other disciplines, and some insurance plans’ resistance to integrative treatment approaches. For now, authors write, the chronic pain landscape is one in which “large numbers of Americans are receiving suboptimal care.”

The release of the report comes at a time when the issue is receiving wider attention, thanks in part to Cake, and a new film starring Jennifer Aniston as a woman with chronic pain. Recently, the Washington Post addressed the issue in an article that called for a “blended approach” to chronic pain, including the use of physical therapy. That story followed up on a January 12 Washington Post article titled “8 ways to deal with chronic pain.” The article’s first recommendation: “embrace physical therapy.”

“The more you move, the better you feel,” reporter Rachel Noble Benner writes in the article. “Strategically strengthening and stretching the body, especially parts that are affected by chronic pain, can increase mobility, decrease pain, and improve overall mood. Find a physical therapist who is experienced in working with people who have chronic pain.”

The Physical Therapists at Blue Ridge Orthopaedic & Spine works exclusively in the treatments of Orthopaedic conditions and have experience working with patients who have chronic pain. In conjunction with your doctor and using evidence-based treatments, we create treatment plans to treat the patient as a whole, not just the injury, and to restore full functionality.

BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center is Northern Virginia’s premier facility for diagnosing and treating back pain and spinal disorders. In addition to our regionally renowned Spine Center, our practice features Joint Replacement, Sports Medicine, Pain Management, Physical Therapy, Trauma Center, Shoulder Care, a Hand Center and a Foot and Ankle Center.

We are committed to treating not just injuries and physical ailments, but rather the whole person, by offering a wide range of specialty programs designed to support treatment. Specialty programs include Massage Therapy, Medical Nutrition and Aquatic Physical Therapy.

APTA has been at the forefront in helping the public understand how physical therapy can be a transformative agent in the treatment of chronic pain. The subject was featured in a Move Forward radio podcast, and the association offers a physical therapist’s guide to chronic pain syndromes. Additionally, the APTA Orthopaedic Section sponsors a special interest group in pain management, and the PT’s role in chronic pain management was featured in the September issue of Motion magazine.

Chronic Pain Coping Techniques – Pain Management

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Article written by: Andrew R. Block, PhD   Spine-Health.com

Clinicians who specialize in treating chronic pain now recognize that it is not merely a sensation, like vision or touch, but rather chronic pain is strongly influenced by the ways in which the brain processes the pain signals.

Chronic pain can provoke emotional reactions, such as fear or even terror, depending on what we believe about the pain signals. In other cases (such as in sports or another engaging, rewarding activity), chronic pain may be perceived by the individual as merely a nuisance, a feeling to be overcome in order to be able to continue in the activity.

The important role the mind plays in chronic pain is clearly recognized in the medical literature, as well as in the International Association for the Study of Pain’s definition of pain, which states that pain is always subjective and is defined by the person who experiences it.

The corollary is that the brain can also learn how to manage the sensation of pain. Using the mind to control chronic pain, or coping strategies, for managing persistent pain, may be used alone or in tandem with other pain management therapies.

Ideally, use of the chronic pain management techniques outlined in this article can help patients feel less dependent on pain killers and feel more empowered to be able to control their pain.

Managing Chronic Pain

Of course, the first step in coping with chronic back pain or other types of persistent pain is to receive a thorough medical evaluation to determine the cause of the pain.

  • In some situations, such as a herniated disc in the spine, it may be important to pay attention to the level and type of pain so that it can serve as a warning signal of impending damage.
  • In other cases, especially when the back pain is chronic and the health condition unchangeable, one goal can be to try and keep the chronic pain from being the entire focus of one’s life.

Whatever the medical condition, there are a number of effective strategies for coping with chronic back pain. These techniques generally include:

  • Relaxation training: Relaxation involves concentration and slow, deep breathing to release tension from muscles and relieve pain. Learning to relax takes practice, but relaxation training can focus attention away from pain and release tension from all muscles. Relaxation tapes are widely available to help you learn these skills.
  • Biofeedback: Biofeedback is taught by a professional who uses special machines to help you learn to control bodily functions, such as heart rate and muscle tension. As you learn to release muscle tension, the machine immediately indicates success. Biofeedback can be used to reinforce relaxation training. Once the technique is mastered, it can be practiced without the use of the machine.
  • Visual imagery and distraction: Imagery involves concentrating on mental pictures of pleasant scenes or events or mentally repeating positive words or phrases to reduce pain. Tapes are also available to help you learn visual imagery skills.

Distraction techniques focus your attention away from negative or painful images to positive mental thoughts. This may include activities as simple as watching television or a favorite movie, reading a book or listening to a book on tape, listening to music, or talking to a friend.

  • Hypnosis: Hypnosis can be used in two ways to reduce your perception of pain. Some people are hypnotized by a therapist and given a post-hypnotic suggestion that reduces the pain they feel. Others are taught self-hypnosis and can hypnotize themselves when pain interrupts their ability to function. Self-hypnosis is a form of relaxation training.

All of the above-describe techniques for coping with chronic back pain make use of four types of skills:

  • Deep Muscle Relaxation
  • Distraction: moving attention away from the pain signals
  • Imagery: visual, sound or other pictures and thoughts that provide a pleasant and relaxing experience
  • Dissociation: The ability to separate normally connected mental processes, leading to feelings of detachment and distance from the chronic pain.

11 Chronic Pain Control Techniques

To prepare for any chronic pain coping technique, it is important to learn how to use focus and deep breathing to relax the body. Learning to relax takes practice, especially when you are in pain, but it is definitely worth it to be able to release muscle tension throughout the body and start to remove attention from the pain.

Coping techniques for chronic pain begin with controlled deep breathing, as follows:

  • Try putting yourself in a relaxed, reclining position in a dark room. Either shut your eyes or focus on a point.
  • Then begin to slow down your breathing. Breathe deeply, using your chest. If you find your mind wandering or you are distracted, then think of a word, such as the word “Relax,” and think it in time with your breathing…the syllable “re” as you breathe in and “lax” as you breathe out.
  • Continue with about 2 to 3 minutes of controlled breathing.
  • Once you feel yourself slowing down, you can begin to use imagery techniques.

Eleven specific imagery and chronic pain control techniques that are effective for pain control include:

  1. Altered focus
    This is a favorite technique for demonstrating how powerfully the mind can alter sensations in the body. Focus your attention on any specific non-painful part of the body (hand, foot, etc.) and alter sensation in that part of the body. For example, imagine your hand warming up. This will take the mind away from focusing on the source of your pain, such as your back pain.
  2. Dissociation
    As the name implies, this chronic pain technique involves mentally separating the painful body part from the rest of the body, or imagining the body and mind as separate, with the chronic pain distant from one’s mind. For example, imagine your painful lower back sitting on a chair across the room and tell it to stay sitting there, far away from your mind.
  3. Sensory splitting
    This technique involves dividing the sensation (pain, burning, pins and needles) into separate parts. For example, if the leg pain or back pain feels hot to you, focus just on the sensation of the heat and not on the hurting.
  4. Mental anesthesia
    This involves imagining an injection of numbing anesthetic (like Novocain) into the painful area, such as imagining a numbing solution being injected into your low back. Similarly, you may then wish to imagine a soothing and cooling ice pack being placed onto the area of pain.
  5. Mental analgesia
    Building on the mental anesthesia concept, this technique involves imagining an injection of a strong pain killer, such as morphine, into the painful area. Alternatively, you can imagine your brain producing massive amount of endorphins, the natural pain relieving substance of the body, and having them flow to the painful parts of your body.
  6. Transfer
    Use your mind to produce altered sensations, such as heat, cold, anesthetic, in a non-painful hand, and then place the hand on the painful area. Envision transferring this pleasant, altered sensation into the painful area.
  7. Age progression/regression
    Use your mind’s eye to project yourself forward or backward in time to when you are pain-free or experiencing much less pain. Then instruct yourself to act “as if” this image were true.
  8. Symbolic imagery
    Envision a symbol that represents your chronic pain, such as a loud, irritating noise or a painfully bright light bulb. Gradually reduce the irritating qualities of this symbol, for example dim the light or reduce the volume of the noise, thereby reducing the pain.
  9. Positive imagery
    Focus your attention on a pleasant place that you could imagine going – the beach, mountains, etc. – where you feel carefree, safe and relaxed.
  10. Counting
    Silent counting is a good way to deal with painful episodes. You might count breaths, count holes in an acoustic ceiling, count floor tiles, or simply conjure up mental images and count them.
  11. Pain movement
    Move chronic back pain from one area of your body to another, where the pain is easier to cope with. For example, mentally move your chronic back pain slowly into your hand, or even out of your hand into the air.

Some of these techniques are probably best learned with the help of a professional, and it usually takes practice for these techniques to become effective in helping alleviate chronic pain. It is often advisable to work on pain coping strategies for about 30 minutes 3 times a week. With practice, you will find that the relaxation and chronic pain control become stronger and last longer after you are done.

Sometimes, after you are good at using the techniques, you can produce chronic pain relief and relaxation with just a few deep breaths. You can then start to use these techniques while you are engaged in any activity, working, talking, etc. With enough experience you will begin to feel a greater sense of control over the chronic pain and its effects on your life.

 

BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton  office at 540-347-9220 or our Gainesville office at 703-743-2814.

Don’t ignore your pain. Relieve it with us!

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The effective management of chronic pain can often be the difference between a difficult life and a comfortable one.  At Blue Ridge Orthopaedic & Spine Center, we offer the expertise and alternatives you need to get back to everyday living.

What is Pain Management?

Pain management is a branch of medicine that applies the latest in treatment methods to reduce or control pain.  Our doctors specialize in a variety of solutions including pharmacological, interventional, and alternatives to reduce or control pain.

At Blue Ridge Orthopaedic & Spine Center, our pain management group offers a variety of options tailored to address all of our patients’ pain management needs.  We offer inpatient, outpatient, surgical and non-surgical services, as well as cutting-edge, minimally invasive pain management treatment for patients with acute or chronic pain.

Our physicians are fellowship trained and board certified by the American board of medical Specialties in pain medicine.  We have the most advanced training and certifications available for pain medicine interventions and treatments.

Pain Management Services for all Pain Conditions

  • Complex pain and spine disorders
  • Acute and chronic pain management
  • Diagnostic and therapeutic interventional procedures
  • Electrodiagnostic testing
  • Neuromodulation for chronic pain management

The Best Solution for Your Situation

No matter what you’re dealing with, our pain management specialists work closely with the surgeons and physical therapists at Blue Ridge Orthopaedic & Spine Center in a multidisciplinary approach to develop a unique treatment plan that best suits each of our patient’s needs.  To schedule an appointment with the pain management specialists at Blue Ridge Orthopaedic and Spine Center, please call 540.347.9220 (Warrenton location) or 703.743.2814 (Gainesville location).  Visit www.broava.com for more information on the comprehensive services offered @ Blue Ridge Orthopaedic & Spine Center.

Our goal is to get YOU back to GOOD health!

What is Pain Management?

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Pain management is a branch of medicine that applies the latest in treatment methods to reduce or control pain.  Our fellowship trained, board certified pain specialist’s specialize in a variety of solutions including pharmacological, interventional and alternatives to reduce or control pain.

At Blue Ridge Orthopaedic and Spine Center, our pain management group offers a variety of options tailored to address all of our patients’ pain management needs.

Comprehensive Pain Management Services for all Pain Conditions

  • Complex pain and spine disorders
  • Acute and chronic pain management
  • Diagnostic and therapeutic interventional procedures
  • Electrodiagnostic testing
  • Neuromodulation for chronic pain management

 Blue Ridge Orthopaedic and Spine Center offers inpatient, outpatient, surgical and non surgical services, as well as cutting-edge, minimally invasive pain management treatment for patients with acute or chronic pain.  For more information, please contact one of our pain specialists @ 540.347.9220 (Warrenton location) or 703.743.2814 (Gainesville location).  Also, don’t forget to visit www.BroAva.com for more information on the comprehensive services offered by Blue Ridge Orthopaedic & Spine Center.