Chronic pain
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- Chronic pain syndromes
- Fibromyalgia and soft tissue dysfunction
- Nerve Pain/Neural pain/Neuropathic pain
- Frozen Shoulder
Chronic pain syndromes
According to the International Association for the Study of Pain (IASP 2025); pain can be defined as: “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.
Six key notes and etymology:
- Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.
- Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons.
- Through their life experiences, individuals learn the concept of pain.
- A person’s report of an experience as pain should be respected.
- Although pain usually serves an adaptive role, it may have adverse effects on function, social and psychological well-being.
- Verbal description is only one of several behaviours to express pain; inability to communicate does not negate the possibility that a human or a non-human animal experiences pain.”
Chronic Pain or Nociplastic Pain
Chronic pain is a complex problem and needs a multi-faceted approach. These conditions need to be assessed and explained on an individual basis, as each person is different. The physiotherapeutic approach to chronic pain involves education, manual therapy, lifestyle changes, cognitive behavioural therapy, exercise prescription, maintenance therapy and working in a multi-disciplinary team. Chronic pain should be tackled with a team approach where the patient is the captain. The importance of attending to the mobility of all the structures is vital. Various methods exist to address muscle pliability and flexibility. The treatment options for nerve mobilisations are vast and the importance of specific exercises is crucial to success. Treatment aims are to improve the function and quality of life of the chronic pain sufferer.
Fibromyalgia and Soft Tissue Dysfunction
Fibromyalgia is a complex musculoskeletal disorder that can be accompanied with fatigue and sleep disturbances, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals (Mayoclinic). Fibromyalgia and chronic pain is a complex problem and needs a multi-faceted approach. These conditions need to be assessed and explained on an individual basis, as each person is different. The physiotherapeutic approach to chronic pain involves education, manual therapy, lifestyle changes, cognitive behavioural therapy, exercise prescription, maintenance therapy and working in a multi-disciplinary team.
Frozen Shoulder
Frozen shoulder, also known as Adhesive Capsulitis, is a condition characterised by pain and stiffness in the shoulder. Usually the pain starts slowly, most often with no mechanism of injury and gradually gets more painful and limiting. The next stage is followed by less pain and more stiffness and eventually the condition resolves in 14 months, and can take up to 3 years. Managing of a frozen shoulder usually involves a team approach. However, making sure that the condition is correctly diagnosed is also important. Physiotherapy can assist with pain management in the initial stages, and as the pain settles and stiffness sets in, maintaining mobility and assisting with activities of daily living becomes important. It is important to move in the available range and maintain function as much as possible.