Physical Therapy

Chronic pain can interfere with the ability to carry out many vital activities of daily living, including self-care, work, relationships, hobbies, and even sex.

Physical function is the bodily activity necessary in daily living and depends on the cooperative movement of different body parts in a multi-linked series.  For this reason, it can be somewhat misleading to think of any one body part in isolation from the other body parts that link up with it to create these series.  Lifting, for example, requires a series of linked motions stretching from the feet through the spine and up to the hands.  The failure of any one link in the series is capable of disrupting the entire series and thus significantly impairing function.

Activities of daily living are usually described in terms of such easily recognizable physical tasks as sitting, standing, squatting, kneeling, walking, tying shoes, carrying groceries, driving a car, etc...  On the biomechanical level, however, we can break down the various aspects of these tasks into smaller component movements: flexion, extension, adduction, abduction and rotation. Practically speaking, these play a role in all forms of physical movement. The other major components are neurological control and muscle activity which work in a dynamic interchange that results in the various forms of coordinated muscle contractions and relaxations. By identifying the problematic component of the impaired activity, it is possible to design a treatment program that restores function by either strengthening the weak link in the chain or developing compensatory strategies to circumvent it.

Physical rehabilitation is important for patients with functional decline from chronic pain. In addition to reducing pain and improving physical function, it can lessen the fear and anxiety that comes from anticipating painful movement. Often, chronic pain patients fear that increasing their activity level will increase their pain.  This can be a major deterrent to their participation in an exercise program. A graded exercise program combined with patient education regarding the deleterious effects that inactivity has on chronic pain and the important benefits of increasing activity may reduce these fears and increase the patient’s sense of self control.

In addition to improving gross motor function, patients need to learn better ways to perform the finer tasks required for daily living and in the work setting. Learning adaptive skills is vital in order for patients to have independent, productive and satisfying lives. Activities of all types, ranging from using a computer to mastering everyday needs such as dressing, cooking and eating may require modification for their successful performance. While physical exercises may be used to increase strength and skillfulness, sometimes special adaptive equipment is needed at home or at work. When the ability to perform in a work environment has been impaired, work re-training and/or new employment may be necessary. Other times, evaluation of the work environment and assistance planning work activities is all that is needed. If needed, modification of the work environment can be done so that the work can be successfully completed.