We all know someone who suffers from chronic pain. 1 in 5 Australians suffer from it with that number increasing to 1 in 3 over the age of 65. Chronic pain conditions include many diagnoses; from those widely recognised with clear bio-mechanical causes such as; arthritis (osteo and rheumatoid), osteoporosis, MS, nerve damage, etc; to those we are rapidly developing our understanding of like chronic lower back pain, and polymyalgia rheumatica; and those whose causes still largely mystify the medical community: fibromyalgia, chronic fatigue syndrome, chronic regional pain syndrome.
It is generally considered chronic, or persistent pain, when it lasts for more than 3 months, or longer than the tissues would normally take to heal. Chronic pain is felt differently by every person. It can be mild or quite severe, sharp or blunt and achy. For most people with chronic pain, it is felt on most days and can very in intensity depending on how much and what type of activity the individual does on that day.
As we mentioned in the previous blog, pain signals are carried by nervous system to the brain to indicate danger and/or damage. This isn’t always the case with chronic pain. During chronic pain, our body will send these pain signals even though there is no risk to tissues or long after the initial injury has healed. Sometimes these pain signals even get mixed up and start coming from a different part of the body to where the initial injury was located.
With this sort of pain, it is important to have a multidisciplinary approach. This means involving more than one type of healthcare professional in a person’s care. As more than 40% of chronic pain patients admitted to hospital with chronic pain have a diagnosis involving the muscles and/or bones, physiotherapists are often a key member of the multidisciplinary healthcare team for chronic pain. Studies have also shown that a graded approach to exercise can be crucial in decreasing pain, increasing function, and improving an individual’s quality of life.
Chronic pain can be like a roller coaster where an individual will feel good one day and terrible the next. This often occurs when someone feels well and tries to get as much done as they can whilst they feel well…only to over do it and be in intense pain the next day. This becomes a roller coaster of pain and dysfunction. One of the most effective treatments for this pattern of pain is graded exercises. This involves first discovering how much exercise or other work they can do without suffering from a flare-up soon after. Using this as a baseline, we can very slowly increase the amount of exercise that a person can tolerate before flare-up. This technique has proven to be very effective when accompanied by education and advice of a trained healthcare professional. Or better yet, a team of trained healthcare professionals.
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