Pain – www.specialist.physio

What is Pain Physiotherapy?

Our understanding of pain and pain management is evolving. We are moving away from traditional models of cause and effect. When trauma has occurred, the damaged tissue as the cause of the pain is obvious, but many times people suffer chronic pain long after the tissues have healed. Effective pain therapy requires a biopsychosocial model of care. This takes into account the physiology of pain alongside the cognitive impacts and drivers and the multiple variables of lifestyle and community living which can generate increased suffering and distress.

Pain physiotherapists are particularly skilled in helping people with complex pain problems. Traditional passive treatments of physiotherapy (such as massage and dry needling) are often of little value for people with chronic pain. Instead exploration, education and exercise are used. Thorough investigation of the individual’s pain experience and the thinking patterns association with it are required. Then a tailored program can be developed and implemented in consultation with each person.

Pain physiotherapists often work in multidisciplinary clinics alongside pain medicine specialists, psychologists and occupational therapists. This may include in tertiary hospitals, outpatient clinics, community settings or private practice. Pain physiotherapists may help people in a variety of ways including through assessment, diagnosis, understanding pain, activity pacing, exercise prescription and a range of pain desensitising strategies.

Who can they help?

Some examples of pain physiotherapy practice include:

Complex regional pain syndrome
Widespread pain conditions (such as fibromyalgia)
Multi-site pain
Nerve-related pain conditions
Neuropathic pain
Increased pain sensitisation (peripheral and central sensitisation)
Headache
People with pain after injury that is not improving even when the injury has healed

Specialist Pain Physiotherapy

Specialist pain physiotherapists have attained formal recognition of their expertise via Fellowship of the Australian College of Physiotherapists. This is the highest level of clinical qualification available in Australia.

Specialist pain physiotherapists are often involved in providing second opinions or specialist care for people with these more complex pain conditions. This can work in a variety of different ways. They may provide:

Shared-care (collaboration with the doctor and local/treating physiotherapist or other health professional)
Specialist care (a course of treatment delivered by the specialist physiotherapist, potentially as part of a multidisciplinary approach. Common for more complex cases)
Broader recommendations for management (eg. around diagnosis, recovery expectations and referral to other medical or healthcare specialists).

Every person has their story

John's Story

John had a lifting injury at work 8 months ago and has had ongoing back pain and increasing generalised pain throughout his body. He has tried a number of different treatment approaches (hands-on treatments and exercises) but these have not proved successful. He is confused about what treatment is now appropriate and is feeling increasingly despondent. John really wants to get back to work but is afraid of hurting himself again.

John attends a Specialist Pain Physiotherapist. He receives a thorough assessment which incorporates an evaluation of his pain, his movement and the impact of the pain on his physical and emotional functioning. From this assessment, a plan is generated which addresses his desire to return to work, specific advice regarding the best approach to increasing his physical activity and training in recognising the impact of his mood on his pain. His GP, workplace and family are involved in this treatment planning.