In this age of multimedia I find podcasts a very accessible way to keep up with current thinking and evidence in modern physiotherapy practice.
The podcast focused on the problem of persistent pain and how to better manage it within what’s known as a biopsychosocial approach. The biopsychosocial approach sits well alongside hands on manual therapy, medical acupuncture including dry needling as well as prescription therapeutic exercise when required.
Here are a few key messages:
- Use ‘persistent pain’ or ‘sensitivity’ rather than using the term ‘chronic pain’ – removing the negative language can have a big impact on our clients perception of pain. Although pain often feels very physical, it’s actually a physiological response within the brain and nervous system; the extent to which we interpret pain as threatening effects the severity and duration of pain experienced.
- As physiotherapists we should look at managing persistent pain like medical professionals would any other condition, such as type 2 diabetes for example. Accept that is a condition and then work with our clients to keep it at an acceptable level or in some cases curing it altogether.
- Persistent pain has to be treated using an integrated approach which considers personal and lifestyle factors such as exercise, sleep, diet, stress, relationships and more. These all affect how the nervous system processes the signals the brain interprets as pain, in a sense ‘retraining’ the brain.
- It is important to focus on goals and daily function, instead of constantly zoning in on pain levels. It can be more beneficial for our clients to focus on day to day function and activity levels – what they CAN do, instead of focusing on their limitations. Setting realistic goals and pacing promotes a healthier and improved quality of life.
- A key aspect in the management of persistent pain is helping our clients understand their pain, what it is and how its created within the body. Make the connection between how the brain ‘i.e the boss’ works and the pain our clients feel – this does not suggest that pain ‘is all in the head’, it is about understanding how thoughts and emotions affect the physiology of the brain, which in turn influences our clients sensitivity to pain at any given time.
- Keep it simple, use metaphors and our clients own experiences to help make the information more meaningful, don’t overload with complex information.
- We must understand that our brain and nervous system are complex, and re-training them won’t happen overnight. We must give it time to adapt and alter. We must recognise that each client is different, so one approach may not suit all. The best way to begin, is by listening to our clients and figuring out what they need.
If you are suffering with persistent pain and would like some help, please call us on 01-2834303 for an assessment.
By Katie Farrell, BSc Physio, MISCP Chartered Physiotherapist