Understanding Chronic Pain Management


Chronic pain management is necessary to ensure patients can improve their quality of life and maintain regular levels of activity on a day-to-day basis. Some cases of chronic pain are easily resolved, but in many cases treatment is challenging and may involve exercise, physiotherapy, pharmacological therapy, procedure, surgery and psychological therapy. The aforementioned modalities can be used in combination to treat chronic pain when one single treatment produces insufficient results.

Pain that persists for three or more months is classified as chronic pain. In most cases, treating chronic pain involves management of the underlying cause, which is usually a lesion. When a lesion has occurred, pain results as a protective function: it indicates that something has gone wrong and it triggers neural reactions that prevent the lesion from becoming exacerbated. When pain becomes chronic, it is a sign that this protective function has been lost. Treating pain can very easily become the primary focus of health practitioners rather than the cause of the problem. This should be avoided at all costs and instead the cause should be treated when possible.

One Japanese study on chronic pain identified that instances of chronic pain increase with age. 61% and 75% of all males and females over 65 years old, respectively, reported suffering from chronic pain on a daily basis. Chronic pain in the knees and upper arms was most common. Chronic fatigue was present and seen as related to chronic pain in more males than females.

The diagnosis of chronic pain can involve the use of one of several diagnostic tools. Computer topography (CT) scans, magnetic resonance imaging (MRI) scans and X-Rays are all used in the diagnosis of chronic pain. These imaging techniques allow medical practitioners to peer inside the body and identify the cause of the chronic pain without having to perform invasive procedures. Before imaging is used, however, several questions will be asked of a patient to help doctors identify the approximate location of the pain. For example, “When did the pain start? Where on your body does it hurt? What does the pain feel like? Is it throbbing, pounding, shooting, sharp, pinching, stinging, burning, etc? How severe is your pain on a scale of 1 to 10? What seems to set off the pain or make it worse? Have any treatments relieved it?”

Following diagnosis, treatment can begin. A study conducted in Korea indicates that significant improvements in chronic pain management, overall patient function and range of motion can be achieved by a combination of sustained natural apophyseal glides (SNAG), low-level laser therapy (LLLT) and electrotherapy. Participants in the study who received a combination of SNAG, LLLT and electrotherapy and participants in the study who received a combination of SNAG and electrotherapy displayed remarkable improvements in their Visual Analogue Scale (VAS) pain score and Modified-Modified Schober Test (MMST; to measure range of motion) score. Roland Morris Disability Questionnaire (RMDQ) scores similarly improved for the two aforementioned groups as well as the control group, which received only electrotherapy.

If you are suffering from chronic pain and require physical therapy, please contact Erko Physio today. We can consult with your doctor and attempt to treat the origin of your pain for as long as it takes for you to improve your quality of life and resume participating in day-to-day activities. We have much experience in chronic pain management and can help you with your condition if physical therapy is right for you. Contact us on (02) 9557 9272 or via our contact page to schedule an appointment at Erko Physio today.