Unfortunately, chronic pain is a harsh reality for many people. Chronic pain results from a wide range of issues such as arthritis, surgery, trauma, inflammatory diseases, medical conditions, and stroke. It can present anywhere in the body, including severe lower back pain and severe neck pain amongst other locations. Major improvements have been made in acute pain management, however, some people develop chronic pain states wherein they experience symptoms that seem unlikely to be cured. For such cases, the clinical management should be focused on controlling the pain effectively, maintaining physical activity (within limits), and encouraging routine daily function. This is done in order to prevent deterioration and to avoid any complication arising from inactivity.
This may appear to sound counterintuitive, because we naturally assume that moving or doing any activity will worsen the pain, however, more often than not, pain doesn’t behave like this and therefore there is no logical reason to avoid activity altogether.
While acute pain (due to a recent injury) requires complete cessation of any activity, these rules don’t apply to any form of chronic pain. If the pain is present with or without activity and it has been established medically that the pain is not going to subside, then the best course of action is to make the best of the situation. This can be difficult for chronic pain sufferers, and behavioural modification therapies are often required to break the psychological link between movement and pain.
Coming to terms with the reality of chronic pain can be difficult. Clinicians involved in treating chronic pain must have sufficient experience in managing such situations by communicating effectively with the patient, providing them with credible guidance and advice. Clinicians also need to motivate their patients to improve functionality within their limits and recognise boundaries and limitations.
Chronic pain management often employs treatment options like joint manipulation, mobilizing, and stretching to help provide temporary comfort. Although this is not a permanent solution, it can help to control the condition by reducing pain and providing more functionality. Each case must be analysed and treated as an individual and unique case.
The goal is to provide sufficient self-directed help with periodic physiotherapy intervention that is minimal yet sufficient enough to keep overall symptoms stable. Usually, providing extensive treatments for chronic pain has little to no advantage, especially if the intention is to completely cure the condition. These issues must be recognised and discussed by every clinician involved in the care process.