Mythbusting: Physical Therapy Has to be Painful

 
IMG_4571.JPG
 

Working in the medical profession, most practitioners have heard many tongue-in-cheek references to their specific job titles, roles, and responsibilities. Some can be funny, some misleading, some are a mix of both. As physical therapists, or PTs for short, there have been many words associated with the letters “P” and “T”, such as Pain and Torture or Physical Torture. We’re sure you have heard of others and there is definitely a common theme here which begs the question, “Is Physical Therapy painful?”

At Headquarters Physical Therapy, we understand it’s inevitable patients will come see us who are in pain. The Hippocratic Oath used in modern medicine of, “do no harm” applies to our profession as well. In the context of physical therapy, physical therapists and the interventions we select to help reduce pain should do just that - REDUCE pain. Ultimately with less pain comes less fear and increases self confidence to move and get back to doing what you enjoy prior to becoming injured.

“PAIN SHOULD BE RESPECTED, NOT FEARED”

Each person has their own unique pain experience; this must be respected. This can range in how intensely you feel the pain, how much it impacts your relationship with your body, and how it affects your daily life responsibilities. In short, there are many variables that go into an individual's pain experience and it is up to both the individual and the physical therapist to work together to reconceptualize pain you are experiencing in the moment and use it to help guide the rehab process and put things into perspective. Below we will cover our top 5 common strategies we implement to aid in pain management and lead you to better, faster outcomes.

Education

We at Headquarters Physical Therapy believe that patient education is foundational to building trust between patient and provider as well as beginning the journey to reducing the impact that pain has on someone. When individuals are educated on pain, interestingly, their reported level of pain has been shown to decrease. This is due to the person feeling like they now have some control over their situation and helps to begin the process of actively engaging in the management and treatment of the underlying issue. A thorough evaluation is also key, to rule out any major injury or health issues as pain alone is a very poor indicator of tissue damage. This is why education should be emphasized to help reduce the fear and anxiety associated with pain when an evaluation clears anything serious or needs a referral to another specialist. Being able to build context around your pain while crafting a plan to return to your normal function requires proper education about the situation at hand.

Prioritize Proven and Effective Interventions. Period.

We can’t stress this enough. Recovery is an active process; NOT PASSIVE. An over-reliance on any one health care professional, especially ones where you go and they only do something TO YOU while you lay on a table only creates dependency. We aim to create relationships that create empowerment. Interventions such as manual techniques, soft tissue work (including massage, cupping, tool assisted, massage guns, etc), joint manipulations or adjustments, dry needling or acupuncture, the list goes on and on (no one profession excluded). The benefits of these treatment interventions work for some while for others have no effect. In fact, these interventions can occasionally make someone’s pain worse. This means no one method listed is the end all be all. While for certain individuals, performing a particular hands on treatment might reduce pain in the short term, they should however not be relied on heavily for any long term plans of care or used as “preventative” for any injury.

1-on-1 Interactions

You should be spending ALL of your time with the rehab provider you are going to see for your scheduled appointment time; not an assistant, not an aide, and not a tech. Your time is valuable. You deserve to have the ability to be heard and to have your concerns addressed and applied to your treatment plan in real time. This is true if any hands on treatments need to be adjusted or not performed at all. This especially pertains to exercise progressions as exercise is our preferred treatment intervention. For many chronic conditions such as low back pain, non-specific general exercise programming is as effective at reducing pain as specific low back rehab exercises. This means it's not necessarily about what you do, but how much. If exercise is dosed too high, this can make your pain worse. Conversely, if exercise is dosed too low, especially for a long time, then no improvement will be made. Especially when long term benefits are the goal and reducing risk for re-injury, properly dosed exercise will make the body adapt to the stress placed on it. This improves your overall tolerance to better tolerate stress and mitigate future injury. Exercise is nuanced, and having someone with you is important if adjustments need to be made to keep you moving toward your goals as efficiently as possible. We aim to get everyone comfortable with movement, however, we understand everyone has their own preconceived notions on the topic.

Trusted Network of Experts

Pain is multifactorial and complex. As mentioned before, many variables can contribute to your personal pain experience. Mental health and stress, nutritional habits, poor sleep quality are among a few. What’s important to recognize is whether or not you’re being referred to a different provider if your goals are not being met. Aside from being able to determine the need to see a medical doctor, we are able to assist with and refer out to other healthcare providers in order to make sure other lifestyle factors are addressed to have an impact on your pain.

Looking Past Pain

Pain can certainly challenge your identity, but it should never become your identity. Physical therapy can be viewed as a means to an end in finding answers, getting clarification on what your pain is, how long it will take to get better, and the steps to get there. But that is not where the progress should stop. Physical therapists at Headquarters Physical Therapy take pride in also having extensive backgrounds in coaching and will be able to seamlessly transition focus from pain management and rehab to training. This process is where the long term benefits lie; pushing your body to be better equipped to handle stress and reduce your risk for injury for the future.

We understand coming to PT might be daunting. It also doesn’t help that you may have heard it may be painful. We assure you that it is our intent to keep you well informed and as much as a part of the process as possible to decrease any fear or anxiety you may have about your injury, understand your pain and provide long lasting results that ultimately you will feel confident about performing on your own. If you have any questions or would like to speak with a doctor to learn more we would love to hear from you!