Pain is one of the most common symptoms that may lead someone to seek the help of a physical therapist or other health care professional.
It is a completely individualized experience. We often use different terms to describe it, but it is hard to know if you feel pain the same way as your friends or family feel pain. Some people talk about having a high or low tolerance to pain, but because pain is such a subjective experience, science has not developed accurate ways to measure pain tolerance.
Currently, there are two ways your physical therapist may categorize your pain
Acute pain, often from a nociceptive mechanism, generally results in discomfort locally at the injured tissue. This pain will increase when the injured tissue is provoked or compromised and will decrease when the trigger is removed. For example, if you have a swollen or injured tendon in your shoulder, you may experience pain when moving your arm overhead. That is because the tendon can get stretched, pinched, or compressed during the movement. When you move the arm back down, unloading the tendon, the pain often resolves or at least significantly lessens. A physical therapist will help you identify positions that hurt and positions that do not hurt and provide treatment and exercises to help the injured tissue move more efficiently.
Chronic pain, often from a central sensitization mechanism, results in widespread pain that is often unpredictable. Individuals experiencing it may be hypersensitive to even the slightest triggers. Chronic pain often is related to psychological factors, and has been identified as a characteristic of chronic low back pain, chronic fatigue syndrome, whiplash, TMJ disorder, rheumatoid arthritis, osteoarthritis, and fibromyalgia. The approach to care for chronic pain is often less aggressive because of its unpredictability, and treatment often emphasizes education in addition to exercise and manual therapy. A physical therapist is well equipped to assess and treat disorders resulting in pain.
Because the mechanisms of pain vary, each approach to care will also vary. That being said, there is evidence to suggest that simply understanding pain through educational means, such as reading this article, may result in reduced symptoms.
Your physical therapist will work with you to develop strategies to better understand and manage your pain. Some points to remember
Education is key. When we understand what pain is, we can use it to better guide our movements and activities.
Bed rest may not always be helpful. Despite what we once thought, long periods of bed rest (more than a day or 2) may actually make your pain worse and lead to other medical complications. Your physical therapist can work with you to develop safe levels of activity to help treat your condition.
Regular exercise is important. Routine exercise provides a lot of benefits, such as improving the conditioning of the nervous system, which is responsible for sending pain messages.
Relaxation and imagery exercises can help. We often experience things that can trigger pain (ie, a stressful day, loud noises, an uncomfortable situation, etc). A physical therapist will help you learn ways to relax the body, which can often calm down the nervous system.
General tips when you are looking for a physical therapist (or any other health care provider)
Get recommendations from family and friends or from other health care providers.
When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people with painful conditions.
During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible. Keeping a journal highlighting when you experience pain will help the physical therapist identify the best approach to your rehabilitation.