Chronic Pain

The feeling of pain is nothing but a signal sent down from your brain to different parts of you body, to let you that something is wrong. It's like an alarm system that brings your attention to something specific so that you can address the problem. Usually, once you have resolved the issue, the pain goes away.

If you've had an injury, or a surgery, it typically takes around 6 weeks for the tissues to heal. The next few weeks are important for getting strength back, as well as endurance and flexibility. Within 3 months, you should feel relatively pain-free and able to function just like you did before. This usually involves some physiotherapy, and other types of rehabilitation therapies to help you along the way. 

If you are still feeling pain after 3 months, now you have chronic pain. Medications that reduce pain are only a temporary solution. It is important to find the cause of your problem to get rid of the pain permanently. What happens if you ignore the pain signal? Read below to learn about chronic pain and what you can do about it. 

What is Chronic Pain?

Chronic Pain is any pain that lasts longer than 3 months. This means that the pain you are feeling is not because something is injured, it is simply because the brain thinks it is normal to feel pain. The brain is always learning new things. If you repeat something often enough, it will begin to make a pattern so that the brain can reproduce it without thinking. For example, when you walk you don't always have to think about how to do that. Your brain has a pattern to follow so that it can happen automatically.

The same happens with the pain signal. If you are always triggering your pain signal, your brain will learn that those activities should always be painful. Overtime, if you trigger your pain repeatedly, it will create a pattern that the brain will continue to use even after your injury has healed. This is how people continue to feel pain from an injury several months, and even years, after the original injury occurred.

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Types of Treatments

Physiotherapy

Science is only beginning to understand chronic pain and the variety of effects it has on the body. Although there are still many unknown factors about chronic pain, we know enough to help you manage your pain, reduce it and sometimes even get rid of it completely.

 

Physiotherapists are movement experts and we can help you identify if the pain you feel is justified, or if you have chronic pain from an old injury. From here, we can provide treatment and share strategies for you to manage your pain at home. It is never too early or too late to start training your brain to move without pain and get back to a normal life.

Neurology

The cause of chronic pain is not always obvious. Some people might be told that "it's all in your head" and that "there's nothing wrong". They will often go through multiple tests like X-Rays or MRIs without finding a reason for the pain. This does not mean that the pain is not real. The pain that you are feeling is very real.

A physiotherapist can examine your movements and check for any possible causes of the pain. They can verify if any nerves are being compressed or irritated. They can check to see if any ligaments are injured. These are all things that could cause pain, but can't be seen on an X-Ray or MRI. If there is a cause, a physiotherapist can give you specific recommendations on how to promote healing.

 

If there is no cause, then we can determine that you are feeling chronic pain. If this is the case, a physiotherapist with experience in neurology can help you retrain your brain to move without pain. We do this by working within a pain-free range to start. The goal is to teach your brain that the movements are not supposed to be painful. You should feel some relief after the first few treatments. Your physiotherapist should show you some exercises to make sure that the pain keeps improving, and doesn't come back!

Exercises

When choosing exercises for your chronic pain, you want to make sure that you stay within a pain-free range. If you've been feeling pain for a long time, you might be surprised at how little you can do before triggering your pain. It is very important to not push this barrier during your exercises. Remember, you are trying to teach your brain that movements are not painful.

Depending on where you feel your pain, a physiotherapist can prescribe you specific exercises so that you can target the movements that are usually the most painful for you. They will help you progress until you feel comfortable with your progress. Then you can gradually find things that are more challenging, to get back to your daily activities without pain.

The type of exercise that you do is important. Your brain is most likely to remember how to move without pain if you practice during activities that are meaningful to you. We want to make the changes permanent, so we use activities that you enjoy in the clinic, and in your Home Exercise Program.

Frequency

In order to make the brain understand that movements are not painful, it is important to practice your exercises correctly, and often. Just like remembering a new phone number. You might choose to review it, to make sure you remember it correctly, then you will repeat it to yourself often to make sure that you don't forget it.

The same strategy applies to your movements. You need to make sure that you are moving without pain every time you perform an activity, like walking, or climbing stairs. For this reason, our treatment plans are designed with visits 1 to 2 times per week. 

Duration

The length of treatment has two components. First, the type of session, and second, the total length of the treatment plan.

There are two types of sessions to choose from: regular treatment and complex treatment. Most people with chronic pain benefit from regular treatment sessions, that focus on only one problem. If you have pain in more than one place, sometimes a complex treatment session is beneficial to address more than one problem at once.

For your first treatment plan, we often suggest a duration of 4 weeks. This allows us to see how you progress and how you are doing with your Home Exercise Program. After these 4 weeks, you may choose to continue on your own, or to continue for another treatment plan, which can be for up to 12 weeks.

The duration of your treatment will be discussed with your physiotherapist on the day of your initial assessment. Depending on what the findings are, and what your goals are, you will talk about what type of treatment session is most appropriate and how many weeks you should start with. 

Exercise is Important!

What to expect from your specialist (and what not to):

When you are told that you have chronic pain, you might not be sure what to do next. Your physician has likely recommended a variety of tests that have all come back "normal". The topic of exercise has likely come up, but it might not be clear whether exercise is good or bad. You've likely had a conversation about pain medication.

Here's some information that your physician won't discuss with you:  Exercise can help reduce pain. Any type of exercise will help to increase your blood flow and oxygen levels. This will help your tissues to heal, and reduce any stiffness that may be causing you some discomfort.

Exercise is very important to make sure that you continue to move without pain. You can do this on your own, or with the help of a physiotherapist. The important thing is that you keep yourself moving as much as possible for as long as possible.

Last Modified September 2019