The Role of Physiotherapy in Pain Management

Physiotherapy plays a key role in disrupting the cycle of pain. Conservative treatment strategies, such as manual therapy and exercise, have been proven to influence both the timing and severity of pain. Scientific research in physiotherapy focuses on understanding whether targeted interventions on joints and muscles can improve function and reduce pain.

Pain typically follows a pattern. The initial inflammatory phase usually lasts around six weeks, with slight variations depending on age, gender, and underlying medical conditions. This acute phase is often the most distressing for patients and can lead to catastrophization, where individuals anticipate long-term suffering when, in reality, the pain should start to decline after reaching its peak.

Factors That Influence Chronic Pain

Certain factors can contribute to the persistence of pain, including:

• Fear of movement (avoidance behaviors)

• Heightened pain sensitivity (central sensitization)

• Psychosocial influences (stress, anxiety, or depression)

It’s crucial to remember that pain is processed in the brain, and various factors can either prolong or alleviate it.

The Body Is Adaptable

The human body has a remarkable ability to adapt. This is evident when someone trains at the gym and transforms their physique—whether from overweight to athletic or from underweight to muscular. The same principle applies to rehabilitation.

Even when a joint is painful, strengthening the surrounding muscles can significantly reduce pain and restore function. Numerous studies have shown that improving muscle strength, joint mobility, and flexibility leads to better pain management and overall function.

Taking Action

The goal of physiotherapy is to act on these physical parameters, helping patients regain control over their condition. By focusing on strength, mobility, and flexibility, we can actively reduce pain and improve daily function.

Some examples:

• Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is recognised as an evidence based practise to improve pain and function. (1)

• Eccentric exercise, conventional exercise, scapular and rotator cuff muscle strengthening, rotator cuff strengthening plus pectoralis major strengthening, high-load training, and low-load training were effective for shoulder pain. (2)

If you have any questions or need professional guidance, I’m Yannick Sarton, physiotherapist and osteopath, and I’m available to help.

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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.