What is Chronic Pain?
Pain is a typical experience that all of us feel from time to time. Most of the time, pain is an alarm system telling the body that there is something wrong. As your injury heals and you recover, it is typical for your pain also to reduce. Chronic pain is a different situation in which the pain messages continue well beyond the healing time for the injury.
Chronic pain is characterised by persistent pain occurring most days of the week. It affects almost 1 in 5 Australian adults and costs the Australian health system nearly $139 billion annually!
These are some of the most common types of chronic pain:
What causes chronic pain?
Chronic pain can develop after an initial injury, where the pain message persists well beyond the point at which the injury has healed.
How does this happen?
Well, think of pain as a warning signal. This comes from your brain, based on credible evidence to say your body needs protecting. Sometimes pain signals are too protective, and you get unnecessary warning signals. Physiotherapists now understand that there are many ways our nervous system ends up producing these warning signals.
Conditioning is one of the primary mechanisms that allow chronic pain to persist. There is a well-understood mechanism for why that is the case: The longer you live with pain, the longer your nervous system produces pain and the better it gets at creating it. Your body learns pain!
How does chronic pain happen?
When your body is faced with a harmful stimulus, specific neurons within your tissues respond to these signals. They will send a warning signal that travels to your spinal cord, and then up to your brain. This response mechanism is known as nociception. It is happening all the time, responding to various inputs throughout your body.
When you receive these inputs, it is up to your brain to decide whether or not to elicit a pain response. If there is a pain response, it is also up to your brain to determine how strong that is. The brain makes sense of the information arriving based on a vast amount of previous knowledge. This information includes the current environment you are in, stress levels, actual danger present, any past experiences surrounding it etc.
If your brain believes there is a good enough reason that protection is required, then your brain makes pain. An excellent example of this is if you’ve severely injured yourself on the soccer field in the past. When you return to soccer, your brain will be hyper-aware of this, and you may feel nervous or anxious about another injury. Your brain is trying to protect you!
Chronic Pain Treatment:
Treatment of chronic pain is much more complicated than usual physiotherapy treatment. Traditional treatment techniques can be used, such as;
These treatment techniques can help alleviate discomfort in the short term. However, they do not address the underlying issue.
Treatment of chronic pain requires you to re-think your understanding of pain and how it works in your body. A good physiotherapist can guide you on these principles and provide more information on strategies to tackle chronic pain.
We also know that one of the best ways to retrain your pain system is to move more. You might find this scary or overwhelming at first, but it can help you take steps in the right direction. Speak to your physiotherapist about how to set realistic goals on movement and how best to pace your activities, so you don’t overdo things.
Goals/outcomes of physiotherapy
The goal for the treatment of chronic pain is individual to you. There is good evidence to suggest that with a better understanding of pain and a willingness to try to be more active, patients can experience significant improvement in their chronic pain. You should set realistic goals based around things that you enjoy and may not have been able to do for an extended time.
Frequently asked questions
These are the top questions people have regarding Chronic pain.
1. Can chronic pain go away?
Yes, ultimately, it can. It is not a simple fix, however, and will require significant time and effort on your behalf to make the necessary changes to your lifestyle and behaviours. This, coupled with treatment from your physiotherapist, will give you the best chance at reducing your pain and hopefully alleviating it entirely.
2. Is chronic pain psychological?
Pain is an extraordinarily complicated experience that is influenced by multiple factors; biological, psychological and social. All of these things interplay to cause pain. So while subjective experiences do play a role in chronic pain, they aren’t the entirety of the problem.
3. Can a disease cause chronic pain?
Yes, a disease such as rheumatoid arthritis or cancer, maybe the initial pain experience that you have which then turns into a chronic pain problem. However, not all conditions lead to chronic pain. Pain is influenced by many factors, as discussed earlier, which can all lead to chronicity.
4. Is it helpful to take pain medication?
While we aren’t able to provide advice regarding medication use, it is essential to note that medications mask the symptoms of pain. While this can be helpful in the short term, it doesn’t address the underlying problem. It is best to speak to your local doctor regarding appropriate medication use.
People also ask
How much does physiotherapy cost?
Physiotherapy for chronic pain will cost around $100 for each session required. Treatment of chronic issues will usually extend for a longer time than regular physiotherapy sessions as there will be a lot of work to do. However, this will be balanced out by more significant gaps between sessions for you to work on the exercise programs and advice your physiotherapist has given you. You should expect treatment to last approximately 12 months in total.
Does health insurance cover physiotherapy?
If you have private health insurance with extras cover, then your physiotherapy costs will be partly covered. Your health fund provider can give you a quote with your estimated rebate from physiotherapy treatment. Most clinics will have HICAPS available for you to claim on the spot.