I recently had the opportunity to work with the APTA, MoveForwardPT and John Ware, PT, MS, FAAOMPT, in developing a “Physical Therapists Guide to Understanding Pain.” This resource will help other Physical Therapists, as well Consumers of Physical Therapy, better understand why pain exists. Please share this with your colleagues and let’s keep moving forward (I posted a small portion below with the link to the content)!!!
The International Association for the Study of Pain has defined pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” This definition indicates that pain may result from actual injury to a tissue (ie, bone, muscle, tendon, etc) or the potential for injury to a tissue. Whether actual or potential damage has occurred, however, people will experience pain as real.
Pain is one of the most common symptoms that may lead someone to seek the help of a physical therapist or other health care professional.
Over the past decade, our understanding of how and why pain exists has changed. While pain was once thought to originate at the level of the tissues (eg, if a knee was injured, pain signals originated at the level of the knee), it is now believed that pain is not perceived until the brain concludes there is a potential threat to those tissues. Today’s findings suggest that if a knee is injured, danger signals originate at the level of the knee, these signals are relayed to the brain, and the brain determines if it needs to respond by sending an output of pain. This response is individual—what causes 1 person’s brain to respond, may not cause another’s to do so. This response is based on many different variables.
The recent shift in the understanding of pain has several major implications. First, it changes the way a physical therapist may approach your care. While many health care fields used to focus on the treatment of individual tissues, many physical therapists are beginning to use a “bio-psycho-social” model of pain treatment. In this approach, physical therapists do not solely focus on the tissues of the body (bio), but they also account for psychological and social factors that may be influencing the amount of pain you experience. If you hurt your knee at work, for example, a physical therapist may incorporate different aspects of your work into your rehabilitation. Your physical therapist may design exercises that replicate the positions you assume during a workday or the tasks you perform at work, such as lifting crates, or climbing a ladder. Your physical therapist will also talk to you about any fears that you may have about movement, and help give you the confidence to move safely again.
Second, it can have a wide economic impact. In 2010, it was estimated that the United States spent between $500 billion and $635 billion on the treatment of pain. To put these numbers in perspective, that same year $309 billion was spent treating heart disease, $243 billion was spent treating cancer, and $188 billion was spent treating diabetes. We are spending an enormous amount of money on the treatment of pain, but these numbers could decrease as we better understand why pain occurs.