The Role of Physiotherapy in Pain Management

Physiotherapy for Pain Management | Studio On

Introduction

When joint pain appears, patients are often confronted with a difficult choice. Should they rely on medication, consult a physiotherapist, or consider surgery? In the acute phase, pain is commonly managed with medication to provide comfort while the body naturally repairs damaged tissues. At this stage, pain often reflects an ongoing biological process.

After three months, however, pain is classified as chronic. At that point, its persistence no longer necessarily indicates tissue damage. Understanding this distinction is essential, because treating chronic pain as if it were still an acute injury often leads to ineffective or even harmful decisions.

Understanding Pain Beyond Tissue Damage

When we talk about tissue, we refer to muscles, ligaments, joints, vertebrae, bones, and nerves. In most chronic joint pain cases, these structures have already healed or stabilised. Yet the pain remains.

This persistence is largely explained by changes in how the nervous system processes pain signals. The brain becomes more sensitive, more vigilant, and sometimes overprotective. Pain, in this context, is no longer a direct indicator of damage but a reflection of altered pain regulation.

The Hidden Drivers of Chronic Pain

Chronic joint pain is often associated with physical limitations such as reduced mobility, muscle weakness, or stiffness. But physical factors alone do not explain long lasting pain.

Beliefs, expectations, fear, and previous medical experiences play a major role in how pain evolves. Many patients live with pain for years without receiving appropriate care, often because they were never guided toward a structured and progressive treatment approach.

When facing chronic pain, patients are usually offered three options: medication, surgery, or physiotherapy. The choice between these paths has a profound impact on long term recovery.

Why Surgery Is Often Overvalued

Pain frequently appears when tissues can no longer tolerate routine load. Physiotherapy gradually increases this capacity through targeted exercises that improve mobility, coordination and strength. The process does not push into painful extremes but progressively challenges the system. As capacity increases, sensitivity decreases and the patient regains predictable control over their body.

Chronic Low Back Pain as a Clinical Example

Chronic low back pain illustrates these issues particularly well. Medication can be helpful in the early stages, but long term reliance on painkillers exposes patients to systemic side effects without addressing the root of the problem.

For chronic low back pain, the current gold standard is based on manual therapy combined with exercise based rehabilitation. The objective is not simply to reduce pain, but to restore movement, confidence, and functional capacity.

In specific situations, such as progressive muscle weakness or significant neurological deficits affecting daily life, surgery may be necessary. However, when pain exists without clear neurological impairment, surgery rarely offers better outcomes than structured physiotherapy and carries substantially higher risks.

The Role of Physiotherapy in Modern Pain Management

The Role of Physiotherapy in Modern Pain Management

Physiotherapy occupies a central position between medication and surgery. It provides a direct, active approach to pain management by combining hands on treatment with progressive movement and exercise.

Physiotherapists are trained to assess pain mechanisms, guide safe exposure to movement, and educate patients about their condition. This educational component is crucial, as misconceptions about pain often lead to fear, avoidance, and catastrophisation, all of which reinforce chronic pain.

Modern physiotherapy is no longer passive or symptom focused. It is a dynamic process that empowers patients to understand their pain and regain control over their body.

Taking Back Control of Your Health

Chronic pain does not mean that your body is broken or beyond recovery. It often means that the right treatment strategy has not yet been applied.

I am Yannick Sarton, a physiotherapist with nearly 20 years of clinical experience in managing joint pain and chronic musculoskeletal conditions. If you are unsure about your diagnosis or your treatment options, asking the right questions is the first step toward recovery.

Taking action early, based on science and movement, can change the trajectory of pain and restore long term function.

I provide structured and evidence-based online physiotherapy for patients worldwide, offering clinical assessment, diagnosis, and personalised rehabilitation.

I also receive patients in person at my physiotherapy clinic in Phnom Penh.

You can begin your online physiotherapy session through the dedicated platform:

https://www.studiohealthon.com/online-physiotherapy

More information on clinical standards and supporting evidence is available here:

https://www.studiohealthon.com/online-physiotherapy-clinical-evidence

Yannick Sarton, MSc Physiotherapist

International Online Physiotherapy & In-Clinic Care, Phnom Penh

References:

1. Skou ST, Roos EM. Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice. Clin Exp Rheumatol. 2019 Sep-Oct;37 Suppl 120(5):112-117. Epub 2019 Oct 15. Erratum in: Clin Exp Rheumatol. 2020 Sep-Oct;38(5):1036. PMID: 31621559.

   
   

2. De-Queiroz JHM, de-Medeiros MB, de-Lima RN, Cerdeira DQ. Exercise for rotator cuff tendinopathy. Rev Bras Med Trab. 2023 Feb 3;20(3):498-504. doi: 10.47626/1679-4435-2022-698. PMID: 36793454; PMCID: PMC9904825.