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Understanding Pain: Insights from a Physical Therapy Perspective

Updated: Mar 4


Pain Management Terre Haute

Pain is a complex and multifaceted experience that affects millions of individuals worldwide. From acute injuries to chronic conditions, pain can significantly impact a person's quality of life. In this blog post, we will delve into the intricacies of pain from a physical therapy perspective, exploring its various dimensions and discussing effective strategies for pain management in Terre Haute.


The Nature of Pain


Pain is a multifaceted and subjective experience that involves complex interactions between the body and the brain. It is not simply a response to physical injury or damage but is influenced by a variety of factors, including emotional, cognitive, and social elements. Pain serves as a protective mechanism, alerting the body to potential harm and prompting protective behaviors. However, it can also persist long after the initial injury has healed, leading to chronic pain conditions.


Types of Pain


Research has identified that pain can be of different types, or categories.  Each category has its own characteristics and underlying causes. Nociceptive pain, for example,  is the most common type and results from the activation of nociceptors—pain receptors in the body—in response to tissue damage or inflammation. If you’ve ever had the misfortune of twisting your ankle or accidentally cutting your finger in the kitchen, you’ve felt nociceptive pain. The causes are many such as thermal (i.e. burns), mechanical injuries from tissues being compressed or pulled to give some examples. 


Neuropathic pain, on the other hand, is caused by damage or dysfunction of the nervous system. It is often described as a sharp, shooting, or burning pain and can be challenging to treat. Neuropathic pain may result from conditions such as diabetic neuropathy, postherpetic neuralgia, or nerve compression.


In each example, the brain plays an important role in our experience of pain. The activation of the receptors associated with pain doesn’t always mean we experience pain. Sometimes, the brain ‘edits’ out the incoming signal. Other times, the brain can give us the sensation of pain without the receptors in the body being triggered. For example, a person with an amputated limb feeling pain in their missing foot. 


The Biopsychosocial Model of Pain


The biopsychosocial model of pain emphasizes the interaction between biological, psychological, and social factors in the experience of pain. According to this model, pain is not solely determined by physical factors but is also influenced by psychological and social factors. These factors can modulate the perception of pain and contribute to its intensity and duration.


Biological factors include genetics, physiology, and neurobiology, which can influence an individual's susceptibility to pain and their response to pain treatments. Psychological factors such as stress, anxiety, and depression can amplify the perception of pain and contribute to the development of chronic pain conditions.


Social factors, including cultural norms, social support, and socioeconomic status, can also play a significant role in pain perception. For example, individuals from certain cultural backgrounds may have different attitudes toward pain and pain expression, which can influence their pain experience.


Pain Management Strategies


As discussed above, pain can be felt for different reasons. Physical therapists’ role in addressing pain is to first categorize the type of pain a patient may be dealing with and to identify biopsychosocial factors that are also playing a role in the patient’s experience. 


At Valley Rehabilitation & Performance the assessment system we use in our patient interactions is called Mechanical Diagnosis & Therapy. This system was developed by the late physiotherapist Robin McKenzie out of New Zealand. This assessment system helps the therapist to make a classification of the type of pain in which a patient is struggling. 


Once a category has been established an effective treatment is then selected to help the patient. 


The majority of patients will exhibit a category of mechanical pain. With mechanical pain, patient’s typically will have an injury associated with movements or postures that have led to too much compression or tension on our body’s tissues (i.e.bending over to lift a heavy object with a resulting back injury, running on an uneven surface and twisting a knee). 


Mechanical pain requires a mechanical solution. Examples of mechanical treatments are those that include movement…’exercise’ or hands-on techniques (e.g. mobilization & manipulation). 


If, through the assessment process,  a patient presents with non-mechanical types of pain the clinician would still match the appropriate treatment to the specific type of pain. 


For example, if it is determined that pain is indeed of an inflammatory type (less than 3% of patient would be in this category), than an anti-inflammatory medication can be helpful.


If the pain appears to be more influenced by psychosocial factors, then matching this presentation with pain education and self-management can be used. 


The key to effective treatment is a reliable assessment system that matches the treatment with the patient’s presentation. 


Treatments should not be applied in a haphazard fashion without first classifying the type of pain. 


Valley Rehab: Your Partner in Pain Management


At Valley Rehab, we understand the impact that pain can have on your life. Our team of experienced physical therapists is dedicated to helping you manage pain effectively and improve your quality of life.  Whether you are recovering from an injury or dealing with a chronic condition, we are here to support you on your journey to pain-free living.

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