Pain Management without meds using Physical Therapy


In recent years, a lot of emphases have been laid on the management of pain in patients. There are now specialist pain management teams who are experts in managing pain medically using a variety of drugs.

However, medical therapy is not the only avenue and physical therapy plays an important role in the rehabilitation and management of pain that accompanies various clinical conditions.

Let us take osteoarthritis for example. There is ample evidence suggesting the benefit of exercise therapy in managing pain in these patients.

In addition, they provide strengthening exercises that can increase muscle tone and strength, and can enhance patient mobility.

This begs the questions – what is it that physical therapists can offer?

There are a number of different treatment options that they can discuss with patients to manage pain, and these are listed below.

1. Passive physical therapy - This involves providing treatments without involving any exercise. Some of the treatments include ultrasound therapy, deep heat therapy, ice pack application and even TENS machine application. TENS has been found to be extremely useful in managing post operative pain and even pain secondary to dysmenorrhoea.

2. Active physical therapy - This includes hand-on treatment such as therapeutic exercises, massage therapy, traction treatments, and joint manipulation.

Therapeutic exercises have been defined as ‘bodily movement prescribed to correct an impairment, improve musculoskeletal function, or maintain a state of well-being’.5 It can include aquatic therapy that brings with it a reduced amount of stress on the joints due to buoyancy and therefore a greater ability to provide a range of movement exercises. Exercises are aimed at improving local blood circulation, increase joint mobility and reduce pain significantly. In the event that patients have too much pain, passive ROM exercises are useful to help reduce the pain that occurs due to muscle stiffness and joint contractures.

Massage therapy includes traction-based movement that stretches the muscles gently, thus maintaining their tone and reducing pain. There are a variety of massage therapies that are available, and discussing these in detail is out of the scope of this article. Traction therapy is similar to massage therapy and provides similar benefits.

There is no doubt that physical therapists provide invaluable input in managing pain in patients with a variety of clinical conditions. In working in close conjunction with physicians, they can ensure a great reduction in pain and a significant improvement in the quality of life.

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