Expert Physiotherapy, Chiropractic, and Orthotics Services for Optimal Health

Pain Management: Can Physiotherapy Help?


Posted by Dr. Scott Wilson | 01-May-2023

  • Pain management is an essential consideration for anyone suffering from an injury or chronic condition and physiotherapy offers a non-invasive approach to managing pain that doesn’t carry the same risks or side-effects as pain medications.
  • Passive pain relief modalities, such as hot or cold therapy, electrical stimulation, ultrasound, traction and manual therapy techniques, can help to reduce pain, inflammation, and swelling and are most often used when pain is severe or when you’re simply unable to actively participate in your treatment.
  • The stretching and exercise component of a physiotherapy treatment often follows the acute phase plan and can help with pain management by reducing inflammation, improving flexibility, strengthening muscles, and even releasing endorphins.

For anyone suffering from an injury or a chronic condition, pain management is essential for preserving or restoring their quality of life. While pain medications can provide temporary relief, they’re not always sufficient for managing pain in the long term. They also sometimes come with unwanted side effects and can even lead to dependency. Fortunately, physiotherapy offers a non-invasive approach to managing pain that doesn’t carry the same risks or side-effects. It allows for the identification of the underlying causes or sources of pain that, when combined with various passive treatment modalities, exercises and education, can provide both short and long-term relief.  

Effective Pain Management Starts with a Proper Diagnosis

A critical first step in managing pain, especially over the long term, is having a proper assessment of your condition. This will allow for the development of a treatment plan that’s based on your particular needs; whether due to injury, poor posture, a muscular imbalance or a chronic condition. To effectively diagnose your condition, your Physiotherapist may use a combination of techniques. This could include a review of your medical history, a physical examination, a functional assessment and the use of imaging studies. Based on the findings of your initial assessment, your Physiotherapist will develop a diagnosis and a treatment plan that may include a combination of various passive pain relief modalities, active stretches and exercises, and education on pain management strategies.

Passive Treatment Options for Pain Management

With a proper diagnosis in place, your Physiotherapist may employ various passive treatment modalities or options to help with managing your pain. In this context, passive means that treatments are applied while you remain physically inactive. These treatment options are most often used when pain is severe or when you’re simply unable to actively participate in your treatment. Passive modalities help to reduce pain, inflammation, and swelling and include hot or cold therapy, electrical stimulation, ultrasound, traction and manual therapy techniques like massage and mobilization.

  • Hot or Cold Therapy: Both hot and cold therapy help to manage pain but each has a different effect on your body. Hot therapy involves using hot packs, warm towels, or heating pads to increase blood flow and relax muscles to reduce stiffness. Cold therapy involves using ice packs, cold compresses, or ice baths to reduce swelling and inflammation, and to numb an area in order to provide pain relief. 
  • Electrical Stimulation: This type of therapy uses electrical impulses to stimulate the nerves and muscles in the affected area. It helps to manage pain by temporarily blocking pain signals from reaching your brain, by releasing naturally produced pain-relieving chemicals called endorphins which help to reduce pain and promote a sense of well-being, and by relaxing muscles and reducing painful spasms. Depending on the nature of your condition, it may involve the use of a TENS, NMES or IFC unit to deliver the electrical stimulation.
  • Ultrasound: This type of therapy uses high-frequency sound waves to create thermal and non-thermal effects to help manage pain. Thermal effects refer to the creation of a gentle heat, which can help to relax your muscles, reduce inflammation and reduce pain. The non-thermal effects include cavitation and microstreaming. Cavitation refers to the creation of tiny shock waves and microstreaming refers to the increasing of the movement of cells and fluids within the affected area. Both can help to promote tissue repair and reduce pain.
  • Traction: Traction is typically used to manage pain in the neck and lower back. It helps by applying a gentle pulling force to the affected area and stretching the spine, thereby reducing pressure on the nerves and discs. Most often this involves a manual traction table. 
  • Manual Therapy: Manual therapy is a hands-on treatment that involves the manipulation of muscles, joints, and soft tissues to help manage pain and improve mobility. It includes massage therapy, myofascial release, soft tissue mobilization, and joint mobilization. Massage therapy helps to reduce muscle tension, increase blood flow, and promote relaxation using various techniques such as stroking, kneading, and friction. Myofascial release helps to reduce pain and improve flexibility through the manipulation of the fascia, which is a layer of connective tissue that surrounds muscles and organs. Soft tissue mobilization helps to reduce pain and improve flexibility by manipulating the ligaments, tendons, and fascia surrounding a joint. And, joint mobilization helps to reduce pain and improve mobility by gently moving a joint through its range of motion.  

Active Stretching & Exercise

When many people think of physiotherapy, they often think of active stretching and exercise. Stretching and exercise is often referred to as the active portion of a treatment plan because it requires active participation on your part. For this reason, it often follows the acute phase or is deferred until you’re physically able to participate. Active stretching and exercise help with pain management by reducing inflammation, improving flexibility, strengthening muscles, and even releasing endorphins. 

  • Reducing Inflammation: Inflammation is reduced through increased blood flow, which delivers oxygen and essential nutrients, and by promoting the release of anti-inflammatory substances. This includes anti-inflammatory cytokines, which are small, naturally produced proteins that help to regulate the immune response and prevent excessive or prolonged inflammation.
  • Improving Flexibility: Improved flexibility reduces muscle tension, improves circulation and increases the range of motion in your joints. Tight muscles can cause muscular imbalances while poor circulation restricts oxygen delivery to muscles and tissues. Poor circulation can also lead to a build up of waste products such as lactic acid, and can even cause nerve damage. A limited range of motion in your joints causes pain due to nerve impingements and pressure on the surrounding tissue.
  • Strengthening Muscles: Strengthening muscles can help with pain management by reducing the stress on your joints and on the surrounding ligaments, tendons, and fascia. It reduces muscle tension caused by weakened muscles.
  • Improving Posture: Improving your posture can reduce pain in your joints by reducing the pressure caused by an uneven distribution of body weight. It can also reduce muscle tension, especially in the neck, shoulders, and back, and can improve circulation. It can also help make breathing easier which can reduce the strain on the respiratory muscles.
  • Releasing Endorphins: Endorphins are a type of neurotransmitter that can help reduce pain and improve mood. Because they can inhibit the transmission of pain signals in the nervous system, they’re often called the body’s natural painkillers. They can also improve mood and promote a sense of well-being by activating the reward pathways in the brain, leading to feelings of pleasure and euphoria. In fact, studies have shown that regular exercise can help reduce chronic pain and improve mood by increasing endorphin levels. 

Education and Advice

Your Physiotherapist can also provide advice and education on pain management strategies. This could include such topics as posture correction & body mechanics, work related ergonomics, and lifestyle and activity modification. They can also provide strategies for managing your pain at home including exercises, relaxation techniques and other complementary therapies.

Physiotherapy Can Help with Your Pain Management

If you’re struggling with pain from an injury or chronic condition, physiotherapy can be an effective, non-invasive option. Based on a comprehensive assessment, your physiotherapist can identify the root cause of your pain and develop a personalized treatment plan. Through a combination of passive therapies, such as heat or cold therapy, electrical stimulation, ultrasound, and manual techniques like massage and mobilization, as well as active stretching and exercises to improve flexibility, build strength, and reduce inflammation, you can achieve both short and long-term pain relief, and improve your overall quality of life without relying on medication.

If you or someone you know is struggling with pain, whether from an injury or a chronic condition, contact us today and let our team of highly skilled Physiotherapists show you why, at Physiomed, Healthier Starts Here.


FAQs on Physiotherapy for Pain Management:

Q1: Is physiotherapy effective for chronic pain?

Yes, physiotherapy can be effective in managing chronic pain. Physiotherapists assess and treat a variety of musculoskeletal conditions. These are often the underlying causes of chronic pain. Through a combination of manual therapy, therapeutic exercise, and other modalities, physiotherapy can help to provide pain relief, improve your physical functioning and enhance your quality of life.

Q2: How successful is physiotherapy?

Physiotherapy has proven to be very effective in treating a wide range of conditions. This includes musculoskeletal pain, neurological disorders, and respiratory conditions. In some cases, physiotherapy may even be as effective as surgery or medication, particularly in cases of chronic pain. However, success depends on a variety of factors, including the nature and severity of the condition being treated, your overall health and your level of participation in therapy. Of course, your adherence to the prescribed treatment plan is also a key factor.

Q3: Is it normal to feel pain during treatment?

Yes, experiencing some level of pain or discomfort is not uncommon during physiotherapy. This is especially the case if you’re dealing with chronic pain or a musculoskeletal injury. However, communicating with your physiotherapist will allow them to adjust your treatment accordingly. The key is to challenge you enough to promote healing without causing excessive pain or discomfort.

Dr. Scott Wilson

Dr. Scott Wilson is the Founder & Chairman of Physiomed; one of Canada’s largest franchised networks of inter-disciplinary healthcare clinics. A graduate of Canadian Memorial Chiropractic College, Dr. Wilson founded Physiomed in 1994 and has since grown Physiomed to over 30 clinics in Southern Ontario and British Columbia. With hundreds of practitioners from over a dozen disciplines, Dr. Wilson and Physiomed have helped over 100,000 Canadians with physiotherapy, chiropractic, massage therapy, orthotic therapy, compression therapy and clinical conditioning as part of a program of rehabilitation and health optimization. In addition to helping patients improve their physical and mental well-being, Dr. Wilson has also mentored hundreds of practitioners to provide better care while enjoying more fulfilling careers. He is also a keynote speaker on many health related topics including how physiotherapy, chiropractic and health & wellness treatment can help with stress, weight loss, and unlocking the true potential within to achieve lasting physical well-being.

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