Why You Hurt and How Pain Management Physiotherapy Heals?

You feel pain when your body is trying to protect you from an injury or further damage.  Pain receptors from the injured area send ‘pain signals’ to your brain for it to process them and generate an appropriate response. Pain is a personal experience for everybody, shaped by three universal factors-  Social (Environmental), Physiological and Psychological. Pain management physiotherapy addresses the root cause of pain from physical, psychological, and social angles. This biopsychosocial approach not only reduces pain but also provides long-term control over your health. 

What is Pain?

Pain is a protective signal your body sends to the brain when it is hurt or likely to be hurt. According to the international association for the study of pain (IASP):

“Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.“

The way we feel pain is highly subjective and completely personal. So, pain management treatments are tailored to each patient based on the cause and the intensity of their symptoms. 

What are the Types of Pain? Explained with examples 

There are two types of pain based on how long it stays: acute and chronic. Acute pain lasts less than 3 months.  It is sudden, temporary and protective. Stubbing your toes or suddenly touching a hot pan are examples of acute pain. Chronic pain persists for 3 months or longer. The brain may continue processing pain even after the body has healed. It is not protective in nature and instead affects daily life. Persistent lower back pain or neck pain from long hours of desk work are examples of chronic pain, which usually started as an acute pain in the beginning. 

Chronic vs acute pain

What Causes Pain?

It goes without saying that injury causes pain.  But that’s not the only reason. You can experience pain because of the nerves, brain stress levels, age and other factors. There are six types of pain based on what causes it. 

Why Do We Feel Pain? Pain Science Explained

Detection of potential ‘threat’

Our body has specialized sensory neurons called nociceptors, also known as pain receptors. These receptors are designed to respond only to internal stimuli that they consider potentially damaging, such as temperature, pressure or chemicals. 

Transmission of pain signals

To respond to the stimulus,  the pain receptor releases neurotransmitters within the cells. Neurotransmitters act as chemical messengers in the nervous system, where they transmit the pain signals from the site of threat to the brain. 

Processing of the signals

The signal travels up your spinal cord to the thalamus, which is a particular part of the brain that sends the data to various other parts of the brain. The somato-sensory cortex, for example, identifies where it hurts and what kind of pain it is.  Similarly, the limbic system attaches an emotional response, like fear or anger, to the signal. Finally, the prefrontal cortex evaluates the seriousness of the injury.  Now the brain has enough information to decide if the pain signal is a critical threat to the body.  If yes, it produces the sensation of pain and enables you to react appropriately. 

Response of the body

Once the brain processes all the information,  it sends a signal back to the spinal cord and nerves. The brain can trigger the release of natural painkillers called endorphins to reduce your pain.  It can also release neurotransmitters that increase pain and stimulate the immune system to respond to an injury. 

Can We Feel Pain Without Injury?

Yes, we can experience pain even without injury or damage. Similarly, we can be injured and yet show no signs of pain. That’s because pain is a protective response that our brain creates based on multiple pieces of information, not just physical injury. If your brain decides a stimulus is dangerous, it can increase pain sensitivity even if the tissues are healthy. The brain can also downplay pain signals, especially in high-adrenaline situations where real tissue damage can occur with little or no pain. 

How Does Physiotherapy Help Pain Management?

Pain results from a dynamic interplay of biological, psychological and social factors. Thus, treating pain, especially chronic pain, requires more than just the traditional biomedical model that focuses on physical tissue damage only. This is where pain management physiotherapy comes into play. 

Physiotherapy adopts a holistic, biopsychosocial model to treat pain from all three dimensions of health. Physiotherapists not only address the injured area but also the entire system, influencing your pain sensitivity. This healthcare practice focuses on reducing your pain, restoring function and preventing the pain from returning in the future. The treatments include manual therapy,  exercises, education and lifestyle modifications. 

What is the multimodal approach in Physiotherapy for pain management?

Desensitizing the Nervous System

In chronic pain, your nervous system keeps sending pain signals even though there is no actual tissue damage. So physiotherapy techniques like manual therapy focus on calming the nervous system down. This reduces the frequency of pain signals, providing you with relief. 

Correcting Movement Patterns

Mechanical problems in the body can result in pain.  For example, weak glutes often result in chronic lower back pain.  That is because weak glutes force the lower back to move more than it was designed to. Physiotherapy focuses on strengthening and stretching the affected muscles to restore their flexibility. 

Education as Medicine

Pain education is one of the powerful tools physiotherapists use to help patients heal. They help you understand the reason behind the pain, steps you can take to minimize the sensations and live a healthy life without the fear of recurrence. 

What Are The Pain Management Physiotherapy Treatments?

A common Physiotherapy treatment plan may consist of the following techniques:

• Manual therapy
• Therapeutic exercises
• Acupuncture
• Laser therapy
• Shockwave therapy

Physiotherapists recommend a series of treatments after assessing the severity of your pain, its causes and an accurate diagnosis. The treatment plan is tailor-made to the patient’s unique recovery requirements and health goals. 

What Conditions Can Physiotherapy Treat?

Read more: What is the Science Behind Physiotherapy?

Conclusion

Pain is how your brain protects your body from injury. It is a complex, unpleasant subjective experience that one goes through in response to a perceived threat. A physical injury is one of the common causes of pain.  But other factors can contribute, such as your current physical condition,  stress levels, environment and past experiences. Physiotherapy helps with pain management by treating it from three crucial dimensions of health: physiological, psychological and social.  This multimodal approach not only reduces pain but also improves long-term resilience and confidence in the patients. At Physiotherapy First, we provide patient-centric pain management physiotherapy to help you recover and resume a daily, healthy lifestyle.

Frequently asked questions

Is physiotherapy painful?

No, physiotherapy is not painful, as reported in research papers, patient stories and case studies. The treatments are non-invasive and work by triggering the natural healing capacity of your body. 

How long does it take for physiotherapy to work?

There is no single deadline for recovery because everybody responds to injuries differently. It also depends on how severe your injury is and the healing capacity of your tissues. For mild pain and initial signs,  1-2 weeks of sessions often prove helpful. 

What is pain management in physiotherapy?

Pain management physiotherapy is a comprehensive approach to providing you with short-term relief and long-term recovery.  It empowers patients with the strength and knowledge so they can manage pain and flares independently.