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Chronic Pain Physiotherapy: Symptoms & Treatment

Chronic pain can be a debilitating condition that negatively affects a person's quality of life. Physiotherapy can be an effective treatment option for chronic pain, as it focuses on improving physical function and reducing pain through exercise, manual therapy, and other modalities.

As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.

Chronic pain is a condition that can have a debilitating effect on physical and psychological health. Physiotherapy is s an effective approach to managing chronic pain, with evidence demonstrating its efficacy in improving physical functioning, reducing the severity of pain, and providing psychological benefits.

It may surprise you to hear that pain is a good thing! The sensation of pain is your body’s alarm system letting your brain know that there is a problem that needs to be addressed. If there is a threat to our body’s tissues, a pain signal can help us prevent further damage.

What is Chronic Pain?

Chronic pain is an ongoing condition that can be debilitating and considerably impact an individual's life. It is defined as pain lasting over three months, including chronic primary, persistent, or chronic pain syndromes. Chronic primary pain is usually caused by a medical condition such as arthritis or fibromyalgia, and it can be accompanied by psychological and emotional issues such as depression and anxiety. Persistent pain can arise from an injury that has healed but still causes discomfort, while chronic pain syndromes are often associated with nerve damage.

Chronic pain management requires a multidisciplinary approach incorporating pharmacological, psychological, physical, and social treatments. Physiotherapy is the mainstay of physical treatment for chronic pain management, providing relief through different techniques, including exercise, stretching, massage, and heat therapy. A physiotherapist should assess the individual's needs to develop a tailored plan of care to reduce the effects of chronic pain.

Education about the condition is also essential for effective treatment, including patient education about self-management techniques; lifestyle changes such as stress reduction; postural training; coping strategies; relaxation exercises; pacing activities; goal setting; problem-solving skills, and other appropriate interventions. All these tools must be implemented for optimal long-term chronic pain management.

What does Chronic Pain Feel Like?

When there is persistent pain in damaged tissues, the receptors in the tissue, spinal cord and brain undergo an adaptation that enhances their ability to perceive pain-inducing stimuli. As a result, stimuli that normally would not hurt is now recognized as painful. The brain understands these signals as harm or danger, in areas where there is little to no damage. You may have heard stories of amputees feeling pain in limbs they no longer possess.

Chronic pain can feel like any of the following: burning, aching, shooting, stinging, throbbing, squeezing or stiffness.

A sensitized nervous system can affect how you perceive pain, it can also affect your emotional health. Fear and anxiety of a movement or situation that has been perceived as painful can increase the production of cortisol and other stress hormones, which in turn can lead to the sensitization of our nervous system.

How is Chronic Pain Diagnosed?

Chronic pain is typically diagnosed by your doctor. If pain exists or comes and goes for more than three months, it can be considered chronic pain. An attempt will be made to determine the underlying cause of the pain. Your doctor or Physiotherapist will ask a series of questions to get more information on your pain, including:

  • The location of the pain
  • The intensity of the pain (scale of 0-10)
  • The frequency of your pain
  • The disturbance on your activities of daily living that your pain is causing
  • The things that ease or worsen your pain
  • The amount of stress, worry or anxiety you have in your life
  • Your past history of illness or surgery

Some testing that may need to be performed by your doctor in order to determine the diagnosis include:

  • Blood work
  • EMG tests to test nerve conduction and muscle activity
  • Imaging such as x-ray, ultrasound or MRI
  • Skin sensation, motor control, reflexes and balance testing
  • Urine tests

Chronic Pain Treatment Plan

Chronic pain management is a multifaceted approach requiring a combination of treatments. Physiotherapy for chronic pain can provide a safe and effective treatment plan to help alleviate symptoms and improve quality of life. This section will discuss the various components of physiotherapy for chronic pain, including massage for chronic pain, manual therapy, and rehabilitation program.

Massage for chronic pain has been shown to be effective in reducing inflammation and increasing circulation to the affected area. Manual therapy techniques such as stretching, joint mobilization, and soft tissue manipulation can help reduce muscular tension and improve the range of motion. Rehabilitation programs should include individualized exercises to promote stability, strength building, proprioception training, flexibility training, nerve gliding exercises, posture correction, biofeedback training, and education on self-management strategies.

Physiotherapy treatment plans should be tailored to the individual needs of each patient. The goal is to restore functional movement patterns while decreasing pain levels with minimal risk of injury or adverse effects. Progression of exercises should be gradual, with adequate rest periods in between activities as needed. Regular follow-up visits with a physiotherapist can ensure that progress is being made and adjustments are made if necessary. With dedication and consistency from both the patient and therapist, successful outcomes can be expected from physiotherapy for chronic pain management.

How Can Physiotherapy Help with Chronic Pain?

Releasing Muscle Tension

Your Physiotherapist or Athletic Therapist will perform manual therapy techniques to reduce the tension in the muscles and soft tissues of the body. The less tension, the less pressure there will be on nerves throughout the body and therefore the less pain there will be.

Building Strength and Mobility

An exercise program built to help you regain your strength, mobility in your joints and flexibility in your muscles will help you learn to move again, regain your ability to do perform daily tasks and help teach your brain that movement doesn't have to be painful.

Reprogramming your System

Your Physiotherapist will work with you to reprogram your sensitized nervous system. By gradually releasing muscle tension and, increasing strength and mobility, you can train your brain to realize that not all movement is painful. Once you reduce the anxiety and fear of moving once-damaged tissues, you will be able to reduce the levels of stress-hormones that were causing your system to be over-sensitized.

Reducing Pain

By reprogramming your system, you will gradually feel less pain.

Other Forms of Treatment

Registered Massage Therapy may be a big help with chronic pain as well.  Your Massage Therapist can help to alleviate tension in your soft tissues and stretch and open your joints to allow more fluidity of movement.  This also serves to relax your Central Nervous System, thereby improving overall health and well being physically, mentally and emotionally. 

What are the Best Exercises to Help with Chronic Pain?

The best exercises for you will completely depend on the nature and cause of your pain. We will list some over functional body movement exercises here that would generally be good for anyone with or without chronic pain.

Body Weight Squat

Squat exercise

Stand with both feet hip width apart and facing forward.
Slowly lower your body into a squat position (knees 90°) while keeping your back straight and your knee caps aligned with your second toes. Lean slightly forward just like you were sitting in a chair, keeping your heels on the ground.
Push through your heels and activate your glutes to come back to standing.


Lunge exercise

Stand with both feet hip width apart.
Lunge forward, making sure you land with the heel and your knee stays over the foot, with your knee cap in line with the 2nd toe. Move straight down, creating a 90 degree angle at both knees and at the hip.
Push through the heel and return to the standing position.
Repeat with the other leg if indicated.

Push Up

Push up exercise

Lie on your stomach with your hands beside your shoulders.
Raise your body off the floor by straightening your elbows, keeping your chin tucked in and your body straight as a plank.
Bend your elbows and lower yourself back down to the floor.

This can be done from the knees or toes or could even be done on the wall to make it easier.


Plank exercise

Start in all fours, then prop yourself up on your forearms and toes, with your chin tucked in.
Lift up your body, creating a straight line with your body.
Maintain the position without arching the lower back. Ensure you are activating your core and gluts.

Yoga Sessions Including Exercises that Flow like Downward Dog to Upward Dog dog

Start on all fours with your hands under your shoulders and your knees under your hips.
Push your hips up towards the ceiling and have your arms in line with your torso.
Try to extend your knees and to lower your heels toward the floor as you push your bodyweight towards your legs.
Hold the position.

Slide forwards until you are in a plank. Drop your knees to the floor if needed. Slowly lower yourself to the floor.

Lie prone on the floor. Stretch your legs back, with the top of your feet on the floor.
Inhale and press your hands into the floor, then straighten your arms and simultaneously lift your torso up as you try to make yourself tall by elongating the spine forward.
At this point the elbow creases should face forward.
Lift through the top of the sternum, but avoid pushing the front ribs forward.
Keep your head aligned with the spine and make your neck long.
Hold the position, breathing easily. Lower back to the ground.

Raise up on to your knees and repeat the whole sequence.

Upward dog

Stabilization Superman

Stabilization exercise

Lie on your stomach with your chin tucked in and one arm by your ear.
Activate your pelvic floor muscles and lower abdominals (transversus abdominus) by bringing your belly button inward. Activate your gluts and use them to lift each leg.
Maintain a steady abdominal breathing while you lift your arm and opposite leg off the ground.
Lower your arm and leg back down to the bed and repeat with the other arm and opposite leg.

How can You Prevent Chronic Pain?

It depends on the reason for the chronic pain, but sometimes there is no way to prevent it. As with any pain or injury prevention, the best thing you can do for yourself, is take care of yourself in all ways. Manage your stress with breathing techniques, seeking help or talking to a friend. Keep your body in good condition by eating healthy, drinking plenty of water and exercising regularly. Get regular maintenance with a Physiotherapist, Athletic Therapist or Massage Therapist and check in with one of them as soon as you notice that something is not quite right or starting to hurt in your body.

What is the Fastest Way to Heal from Chronic Pain?

Dealing with chronic pain is never a quick or simple fix.  It can quite often take different types of therapy working together to achieve the best possible results.  It can often take a lot of work on the part of the patient on their own physical, mental and emotional well being. 

Contact Us For Help

Inertia Physio+ offers Kanata and Stittsville exceptional Physiotherapy, Athletic Therapy and Registered Massage Therapy with private treatment rooms, one on one care, a maximum of two patients per hour and treatment focused on the evidence-based practices of manual and exercise therapy. Don’t suffer any longer.  If you have pain or injury, our Kanata and Stittsville Physiotherapy, Athletic Therapy, and Registered Massage Therapy team is here to help you get back to living pain-free life and activities.  Please reach out to us at (613) 672-2200 or for an appointment today! You are also welcome to book online. We also offer direct billing on Physiotherapy and Massage Therapy services whenever your plan allows.


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