Pain serves as an alarm system when you first injure yourself to protect you from further injury. However, when pain lasts longer than 6 weeks, it’s called chronic pain.

In chronic pain, tissue damage has healed, but due to chemicals and hormones the nerves in the previously injured area become more sensitive. Even a gentle touch can provoke pain as more nerves are “overactive”.

Treatment for chronic pain involves improving motor control by teaching your muscles to work efficiently and effectively without ‘flaring’ up pain.

By retraining the brain and the muscles, activity becomes conscious (automatic) rather than subconscious. Repetition of activity retrains the brain to respond more normally to movement and help with pain.

Fear of pain increases the sensitivity causing you to feel more pain. Interestingly, research shows that by changing the way you think about your pain and by moving without increasing your pain, your brain resets the ‘alarm’ limits.

Often when starting treatment for pain, the physiotherapist will use manual therapy (“hands-on” treatment). However in chronic pain, tissue healing is complete and there is no longer any damage so manual therapy becomes less effective in relieving pain. Research shows that active therapy, or exercise, provides a long-term solution to your pain.

Motivation is helped by setting short term goals (days/weeks) and long term goals (months) with your physiotherapist. These should be attainable and not aggravate your pain, providing the stepping stones to get you back to your pre-injury level of activity.

It is important to avoid the “boom or bust” pattern of pain associated with doing too much too soon. Pacing involves a graduated return to pre-injury activity levels and avoids pain flare-ups. A task must be performed within a training zone that doesn’t aggravate pain. Over time, this zone will widen so that you can increase the task without increasing the pain.

A graduated consistent exercise program is proven to result in improved function in daily activities with reduced pain.