ACUTE AND CHRONIC PAIN   

What is acute pain? 

It is a pain of sudden onset usually triggered by an event like an accident or trauma.  Swelling, redness and difficulty moving the body part ensues.  It lasts for 14 days and can be prolonged if not treated appropriately or the person has not sought professional help after 2 weeks.  An example is the onset of back pain after lifting a heavy box.

What is chronic pain?

It is a type of pain that persists after 3-6 months or more even if the reason of the pain has healed or significantly lessened. All tissues that are injured heals. If pain continues, it is because the pain pathways in the body has become overly sensitive and the nervous system, muscles, joints or organs are in a vicious cycle of hypersensitivity.

What is the evolution of chronic pain syndrome?

1. It often starts out with an obvious injury to a body part from a diagnosed disease, mild to moderate trauma, sports, a fall and many others. Less obvious causes are postural habits, repetitive stress and low grade loads over time straining the site of pain. 
2. Nerves get irritated and will start referring pain distant from the origin and will create localized pain at the referred pain sites. Trigger points and myofascial pain can also develop in the muscles and fascia that refer pain farther away.
3. If the irritations are not ameliorated, the tissues, spinal cord and brain that processes the pain experience will start becoming hypersensitive which is called upregulation and produce repetitive pain firing signals even if there is no injury happening anymore. 
4. Depression, anxiety and stress that are part of the syndrome can further trigger the current chronic pain state and broken vicious cycle.

How can a physical therapist specializing in pain management help?

If a person has acute pain, the expert physical therapist will do a comprehensive physical therapy evaluation and come up with a treatment plan to address the condition. The State of New Jersey allows the patient direct access to physical therapy services. In turn, the therapist will inform your primary physician on record of the condition. If the therapist deems the condition to be outside the scope of her practice, you will be given a referral to seek further consult with the appropriate medical professional. If the condition will not improve within 30 days of physical therapy care, you will be referred back to your doctor.

If a person has chronic pain syndrome, most likely you have seen many medical professionals already including a traditional physical therapist. A specialized physical therapist who follows a whole mind body integrative approach will conduct a thorough history and examination to gather a comprehensive list of WHY’s that kept you in the vicious pain cycle loop. During the course of treatment, a multidisciplinary approach might be warranted which includes a specific medical specialist, psychotherapist, health coach, nutritionist, sleep specialist, acupuncture, dentist, visual optometrist and others deemed important for the patient’s success. All factors that have been uncovered in the sessions will be addressed and not just one single factor. 

What should I expect if I undergo this non-traditional, mind-body physical therapy?

Acute pain management is easy and straightforward. A lot of patients in this stage improves fast and often fully recover. However, if acute pain has occurred on top of a chronic pain state, this patient will take a longer time to feel improvement due to the underlying upregulated state. 

Chronic pain syndrome management is more challenging yet it can be very rewarding. There is no silver bullet or instant results. It is a process and often a multidisciplinary approach. The key to success is to consider all the factors contributing to the pain and address everything. It is important to be consistent with the sessions prescribed as each session builds up from the previous session’s outcomes. Missing a session because you feel some improvement, feeling worse or expecting quick results will more likely prolong the problem as resolution of this syndrome takes time. It can take 3-6 months or longer to manage this. The pain did not happen just yesterday, the pain has evolved from a few months to years. Patients should not come only when symptoms are bad. If you only come when the pain gets worse, it creates a big setback as it takes time to control symptoms. Decisions on the frequency and number of sessions are determined initially on the first visit and updated during the course of the treatments upon re-evaluation. 

Successful outcomes mean that your pain is at its lowest that you can live your life again. It means you now have confidence that you can keep them mild or low because you have attained the knowledge and skills of how to handle it.  When your pain is better, you feel happier, energetic, positive and rejuvenated. 

Reference: Patient education brochure from International Pelvic Pain Society, Inc.         www.pelvicpain.org

Seville Physical Therapy is an expert and specialist physical therapy clinic in Tenafly, Bergen County, New Jersey.  Call us anytime at 201-537-4888 or send us an email at sevillept@icloud.com