Unfortunately, chronic pain is a dark reality for many people. Chronic pain results from a wide range of issues such as arthritis, surgery, trauma, inflammatory diseases, medical conditions, and stroke. Major improvements have been made in acute pain management but still, some people develop chronic pain states where they experience symptoms that don’t seem likely 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 so to prevent deterioration and to avoid any complication arising from inactivity. This might sound counterintuitive because we naturally assume that moving or doing any activity will worsen the pain. More often than not, pain doesn’t behave like this and therefore there is no logical reason to avoid activity.
While acute pain (due to a recent injury) requires complete cessation of any activity, these rules don’t apply to any chronic pain. If the pain is present with or without activity and it has been established medically that the pain is not going to go away then the best course of action is to make the best of the worst situation. That being said, this is very easy to suggest by someone who isn’t battling pain all the time but it is a completely different story for a chronic pain sufferer. Behavioral modification therapies are often required to break the mental link between movement and pain.
Coming to terms with the reality of chronic pain is not easy at all. Clinicians involved in treating chronic pain must have sufficient experience in managing such situations by communicating effectively with the patient by providing them with credible guidance and advice. Clinicians also need to motivate their patients to improve functionality within the limits and by recognizing the boundaries/limitations.
Chronic pain management often employs treatment options like joint manipulation, mobilizing, and stretching to help provide temporary comfort and though it is not a permanent solution, it can help bring the condition under control by reducing pain and providing more functionality. Each case must be analyzed and treated individually as each chronic pain case is unique. The goal here is to provide sufficient self-directed help with periodic physiotherapy intervention kept to a minimum but sufficient enough to keep overall symptoms stable. Usually, providing extensive treatments for chronic pain has no advantage especially if the intention is to completely cure the condition. These issues need to be recognized and discussed by every clinician involved in the care process.