Chronic Pain is pain that lasts longer than 3 months. It is not always easy to find the cause of chronic pain. It can be pain that you keep feeling after an injury has healed. Often it is pain that is felt for no known reason. Researchers have found that chronic pain changes the way the brain lets you know you have pain. With chronic pain, the pain messages from the brain replay over and over again.
There are many terms for chronic pain; these include:
- Complex Regional Pain Syndrome (CPRS)
- Reflex Sympathetic Dystrophy (RSD)
- Reflex Neurovascular Pain Syndrome (RND)
- Amplified Musculoskeletal Pain Syndrome
- Chronic Pain Syndrome
- Myofascial pain syndrome, and
Chronic pain is often described as being intolerable, disabling and even alienating. Depending on where the pain is occurring it may feel like a deep, dull ache. It can also be described as feeling like a burning sensation, tingling, stabbing or pins and needles. If the pain occurs in the arm or leg it is often referred to as complex regional pain syndrome (CRPS).
A physical therapy evaluation includes:
A review of any diagnostic testing including X-rays, MRI, CT scan or blood work done by your doctor. You will need to bring the results to the evaluation appointment. You do not need to bring in the X-rays. Dress your child in clothing they can easily move in and that will allow the therapist to easily look at the neck, back and legs.
The evaluation will begin with a medical history review including past medical diagnoses, family history of similar problems, injuries or traumatic events, and review of any recent injury or onset of pain. We will discuss in detail how the pain is affecting your child with sleep, participation in school and other activities.
The physical therapist will examine your child. They will measure movement of the neck, back, arms and legs. The therapist will measure strength, coordination, balance and endurance. The therapist will watch how your child sits, stands and walks. Included in the exam are “specialty” tests which could include measuring leg length, feeling muscles and bones along their spine, testing reflexes and sensation.
At the end of the physical examination the therapist will discuss the results. You and the therapist will discuss a treatment plan. You will discuss how often and how long your child will come to therapy. What you and your child will need to do at home during therapy. Sometimes after the exam it is necessary to send your child back to the referring physician for more testing.
It is likely your physical therapist can help your child and the family in managing pain and improving overall health. It is important to do the home exercises and activities the physical therapist teaches you in order to make progress.
It is also important to talk to your therapist if the pain is getting worse or not improving.
Treatment may include:
- Balance and coordination training
- Endurance training
- Lifting and back education
- Positioning for better sleep, and
- How to carry a backpack.
The therapist may use treatments during the session such as heat, ice, TENS (transcutaneous electrical stimulation), desensitization techniques, kinesiotape, soft tissue massage, myofascial release craniosacral therapy and breathing and relaxation techniques.