By Dr. Norbert Martin, DPT
Pain—it’s the silent setback that can stealthily sabotage your strides in physical therapy (PT). Whether it’s lingering agony from an old injury or the soreness stemming from your exercise regimen, pain can pose a significant barrier to adhering to your PT routine.
But here’s the unvarnished truth: sidestepping physical therapy due to discomfort only prolongs your path to recovery and could culminate in less favorable outcomes. Fortunately, there’s a beacon of hope—strategies exist that empower you to triumph over pain, ensuring it doesn’t thwart your journey to harness the full spectrum of benefits PT provides.
Forge a Partnership With Your Therapist
Your physical therapist isn’t just a practitioner; they’re your partner in the pain management process. Transparency about your pain—its intensity, epicenter, character (be it burning, shooting, or a dull throb), and its restrictive repercussions—is pivotal. This dialogue enables your PT to tailor your exercises, repetitions, resistance levels, and progression to maintain a therapeutic threshold without exacerbating your pain.
Don’t Brave It Alone
A degree of discomfort is par for the course in PT, but severe pain shouldn’t be masked by sheer willpower. Alert your PT if an exercise induces sharp, escalating, or concentrated pain rather than a mild muscular burn. They can then modify your regimen and suggest interventions like ice, heat, electrical stimulation, massage, or dry needling to alleviate your discomfort.
Embrace Pain-Relief Practices
Consult with your PT about pre- and post-session techniques to mitigate pain:
Administering anti-inflammatory medication (with your doctor’s consent)
Icing the area pre-exercise to diminish inflammation
Applying heat post-workout to boost blood flow and relax muscles
Engaging in gentle, pain-free stretches to enhance mobility
Heed Your Body’s Signals
Pushing through temporary discomfort is expected, but heed your body’s thresholds. If an exercise triggers sharp, unbearable pain or a significant post-activity pain spike, it may be counterproductive. Your PT can introduce alternative methods to ensure safe, continuous progress.
Explore Innovative Modalities
If your progress plateaus or pain persists, consider new techniques like:
Dry needling for trigger point release
Cupping therapy to augment circulation
TENS units for electrical nerve stimulation
Ultrasound to foster deeper healing
Kinesiology taping for muscle and joint support
Maintain Momentum
Consistency is the cornerstone of incrementally enhancing strength and mobility, allowing tissues to adapt. Adherence to your home exercise plan is as crucial as the PT sessions themselves. Avoid prolonged breaks that can lead to regression and protract recovery. Celebrate your victories, navigate through temporary hurdles, and trust that adept pain management will pave the way to your rehabilitation objectives.
The Role of Mindset in Pain Management
The journey through physical therapy isn’t solely a physical endeavor; it’s a mental marathon too. Cultivating a positive mindset is instrumental in pain perception and treatment efficacy. Techniques like mindfulness and relaxation can initiate an ‘upward spiral,’ bolstering resilience and fostering goal engagement, which is vital for chronic pain self-management.
Incorporate mindfulness and relaxation into your routine with:
Guided imagery: Visualizing tranquil scenes to divert from pain.
Deep breathing: Slowing your breath to induce a state of calm.
Progressive muscle relaxation: Sequentially tensing and relaxing muscles to release stress.
By adopting these practices, you can reclaim control over your pain and empower your PT journey.
Don’t let pain derail your physical therapy progress. Collaborate closely with your therapist, attune to your body’s cues, and employ the above strategies to navigate through discomfort. Persisting on this path will unlock the utmost recovery benefits that physical therapy promises.
References:
Schofield P, Dunham M, Martin D, et al. Evidence-based clinical practice guidelines on the management of pain in older people – a summary report. British Journal of Pain. 2022;16(1):6-13. doi:10.1177/2049463720976155
Chimenti RL, Frey-Law LA, Sluka KA. A Mechanism-Based Approach to Physical Therapist Management of Pain. Phys Ther. 2018 May 1;98(5):302-314. doi: 10.1093/ptj/pzy030. PMID: 29669091; PMCID: PMC6256939.
Gagnon, CM.; Scholten, P; Atchison, J. “Multidimensional Patient Impression of Change Following Interdisciplinary Pain Management.” Pain Practice, November 2018.
Majeed, M. H., Ali, A. A., & Sudak, D. M. (2018). Mindfulness-based interventions for chronic pain: Evidence and applications. Asian Journal of Psychiatry, 32, 79–83. https://doi.org/10.1016/j.ajp.2017.11.025
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