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Physical Therapy

What is physical therapy ?

Chronic pain can easily make anyone afraid of physical activity, especially if the pain is triggered by specific movements. This teaches the brain to send pain signals more frequently when there is movement. Physical therapy trains the nervous system to trust movement again. It also improves strength and mobility and ideally it will significantly diminish your pain.

The first physical therapy session will involve an initial evaluation. The physical therapist will want to determine your range of motion, posture, balance, strength, and endurance. From there, a plan will be made to help you heal.

What Types of Physical Therapy are There?

There are a lot of different ways to approach physical therapy. Examples include, but are not limited to:

  • Ultrasound heating applied to the skin. This improves circulation.

  • TENS unit and electrical stimulation which uses electricity to decrease pain signals from the brain.

  • Massage therapy

  • Dry needling is like acupuncture. A physical therapist will use tiny needles to pierce muscles and knots.

  • Heat and/or ice

  • Pain Neuroscience education

  • Exercise

  • Mirror visual feedback w/ a 3D augmented reality involves using a mirror to trick the brain into thinking movement has occurred without pain.

  • Weight management

  • Sleep improvement

The exercise portion of physical therapy can be categorized as land-based vs. water-based, aerobic, strength, and flexibility. Aerobic exercise includes walking, stationary biking, and swimming. Ideally, you should keep the intensity from low to moderate. This can be determined by your heart rate. The goal is to keep your heart rate at 50-60% of its maximum. Meaning, if your maximum heart rate is 160, you should keep your heart rate at 80-96 while exercising.

Strength training includes free weights, resistance machines, elastic bands, and underwater resistance. This is known to be safe and effective. I have found the most improvement from my strengthening exercises. Flexibility training improves joint range of motion and reduces muscle stiffness. It is also known to help with anxiety and depression.

Movement therapies are also encouraged. These are usually yoga, Qigong, and Tai Chi. I do yoga everyday and it has made a huge difference. I have also found improvement in pain levels with pilates.

Benefits

Engaging in physical activity improves sleep, elevates your mood, and decreases inflammation within the body. There can also be weight loss which takes pressure off of the joints. And ultimately, it can reduce your pain. Work with a physical therapist and find what’s right for you.

Sources

Sears, B. (2021, March 17). Take control of your chronic pain with physical therapy. Verywell Health. Retrieved October 15, 2021, from https://www.verywellhealth.com/pt-for-chronic-pain-4179087.

Coronado, R. A., & Bialosky, J. E. (2017, June 12). Manual physical therapy for chronic pain: The complex whole is greater than the sum of its parts. The Journal of manual & manipulative therapy. Retrieved October 15, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498791/.

Alex Benham. (n.d.). Mirror therapy. Physiopedia. Retrieved October 15, 2021, from https://www.physio-pedia.com/Mirror_Therapy.

Saper RB;Lemaster C;Delitto A;Sherman KJ;Herman PM;Sadikova E;Stevans J;Keosaian JE;Cerrada CJ;Femia AL;Roseen EJ;Gardiner P;Gergen Barnett K;Faulkner C;Weinberg J; (2017, July 18). Yoga, physical therapy, or education for chronic low back pain: A randomized noninferiority trial. Annals of internal medicine. Retrieved October 15, 2021, from https://pubmed.ncbi.nlm.nih.gov/28631003/.

Ambrose, K. R., & Golightly, Y. M. (2015, February). Physical exercise as non-pharmacological treatment of chronic pain: Why and when. Best practice & research. Clinical rheumatology. Retrieved October 15, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534717/.

Grinberg, K., Weissman-Fogel, I., Lowenstein, L., Abramov, L., & Granot, M. (2019, December 12). How does myofascial physical therapy attenuate pain in chronic pelvic pain syndrome? Pain research & management. Retrieved October 15, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930783/.