1 – What is pain?

Pain is a complex and unpleasant sensation that can be caused by a variety of factors, including stress, injury, and underlying medical conditions. A physiotherapist understand that pain is a general term that describes uncomfortable sensations in the body and is caused by the activation of the nervous system. Pain can vary in intensity, from a minor annoyance to a debilitating condition.

The process of feeling pain begins when a signal is sent through nerve fibers to the brain for interpretation. This can result in a wide range of sensations, from sharp stabs to dull aches.

While pain can be a significant source of discomfort and can have a major impact on an individual’s quality of life, there are many skilled physiotherapists who can help individuals manage and reduce their pain. With the right treatment plan and support, it is possible to regain control and improve quality of life.

2 – What is involved in an assessment when pain is the nature of the complaint?

The first step in assessing a patient’s pain is to review their medical history in detail. During this process, a physiotherapist may ask questions such as:

  • How did the pain start?
  • What makes the pain better or worse?
  • Where is the pain located?
  • Has the pain improved or worsened over time?

After a thorough subjective assessment, the physiotherapist will typically conduct a physical examination to evaluate:

  • How the patient is moving
  • How various pressures affect the pain
  • Strength
  • Range of Motion (ROM)
  • How the body reacts to various movements

To quantify the pain levels, the physiotherapist may use pain measurement questionnaires such as the Brief Pain Inventory or the Pain Rating Scale. These tools help us to understand the patient’s pain levels and make an appropriate plan of action to improve them.

3 – How would physiotherapist services vary if the patient is unable to communicate?

Assessing pain in patients who have difficulty communicating verbally or have a neurological condition starts with a comprehensive understanding of their medical history and current pain medications. It also considers any communication challenges they may have (i.e., blindness, deafness, etc).

When a patient is unable to communicate verbally, we pay close attention to their body language and facial expressions as they can provide clues about their pain levels. Non-verbal pain management scales, such as the Abbey Pain Scale, which was developed specifically for patients with dementia, and observational objective measures can also be used to assess pain.

In cases where the patient has a neurological condition, we focus our tests on the nerves themselves. This may include testing for nerve shortening or lengthening (i.e. testing hamstring flexibility), pressure, reflexes, and strength to evaluate the condition and identify the cause of pain.

4 – What is the difference between acute and chronic pain?

Acute pain is often associated with an injury or tissue damage and is characterized by an inflammatory response, typically lasting for less than three months. This type of pain is considered short-term and usually resolves as the tissue heals.

Chronic pain, on the other hand, is defined as pain that lasts for more than three months. This type of pain can persist even after the tissue has fully healed. It is often related to the Central Nervous System (CNS) and can be described as an over-sensitive response, causing recurrent pain

5 – What are the primary ways most individuals can reduce their pain with the help of a Physiotherapist?

  • General education
  • Lifestyle modifications
  • Manual therapy
  • Stretching
  • Hydrotherapy
  • Exercise
  • Massage
  • Balance work
  • Rehabilitation equipment

6 – What are some lesser-known pain management strategies?

  • Mirror therapy: A method of treatment that uses a mirror to create the illusion of movement in a affected limb, to help improve the range of motion and decrease pain.
  • Detailed pain education: Understanding the causes, triggers, and ways to manage pain through education and self-management strategies.
  • Graded exposure: A method of treatment that gradually exposes the patient to a certain activity or movement they are fearful of, to help them overcome their fear and improve function.
  • Pacing: A technique that involves planning the day to perform activities that will build capacity, allowing the patient to be more active and manage their pain.
  • Music therapy: Using music as a form of therapy to help patients relax, manage stress, and improve their emotional well-being.
  • Breathing exercises: Techniques that focus on breathing patterns and rhythm to help reduce pain, improve relaxation and control breathing during physical activity

7 – What are the lifestyle factors that we can control that may lower pain?

  • Weight: The patient’s body weight can have an impact on their pain levels and mobility.

  • Diet: The patient’s diet can affect their overall health and contribute to pain and inflammation.

  • Amount of physical activity: The patient’s level of physical activity can affect their pain levels and mobility.

  • Smoking: Smoking can have a negative impact on overall health and contribute to pain and inflammation.
  • Stress: High levels of stress can contribute to pain and affect overall health.
  • Alcohol: The patient’s alcohol consumption can affect their overall health and contribute to pain and inflammation.
  • Sleep: The patient’s sleep patterns and quality of sleep can affect their pain levels and overall health.
  • Home environment: The patient’s home environment can affect their mobility and pain levels.
  • Assistive equipment: The patient’s use of assistive equipment can affect their mobility and pain levels.
  • Footwear: The patient’s footwear can affect their mobility and pain levels.
  • Beliefs/behaviours: The patient’s beliefs and behaviours can affect their pain levels and overall health.
  • Social factors: The patient’s social support and overall social environment can affect their pain levels and overall health.

Family Physio provides holistic healthcare, with the support of Occupational Therapists and Exercise Physiologists who may assist in addressing these factors.

8 – What would be inside a physiotherapist pain management program for an individual?

An example would be if a Family Physio patient presented with ankle pain we would:

  • Examine the condition to diagnose the cause of the pain
  • Perform specific assessments of the ankle
  • Explain the condition to the patient
  • Consider patient goals
  • Treat the ankle using evidence-based therapy
  • Provide education on rest, rehabilitation, and other supports
  • Create an individualized exercise program with specific exercises, sets, and repetitions
  • Develop Exercise progression and home exercise program
  • Review goals and objectives
  • Detail and store information on patient’s file and issue documentation with exercises, updated regularly.

9 – Are there pain management specialisations for a Physiotherapist?

Yes. There are many different pain specialisations, such as:

  • Working inside pain management wards of hospitals
  • Postgraduate degrees
  • Focusing on a particular body part, such as Orofacial pain

10 – How does Family Physio help the community manage or reduce pain?

At Family Physio, our team of clinicians are experts in the field of pain management. With years of experience in both community and residential settings, we have a deep understanding of various pain management programs such as ACFI 4A and 4B. We offer a range of pain management solutions for NDIS, Home Care Package, and residential aged care Physiotherapy patients. Our approach is holistic, and we provide healthcare with trust, compassion and care. If you or someone you know could benefit from our services, please reach out to us via our contact page.