Chronic Pain
Chronic pain is pain that persists for longer than three months, extending beyond the normal healing time of an injury or condition. It can affect people in different ways and may continue even when there is no ongoing tissue damage.
Chronic pain often involves more than just persistent discomfort. It can impact mobility, energy levels, sleep, mood, and overall wellbeing, significantly affecting day-to-day activities and quality of life.
Treatment for chronic pain focuses on managing symptoms, restoring function, and improving quality of life. This is often achieved through a combination of graded physical activity, education, self-management strategies, and, where appropriate, carefully monitored
medication prescribed by your healthcare team.
How Can Physiotherapy Help?
Physiotherapy plays an important role in helping people manage chronic pain by improving physical resilience, increasing confidence in movement, and supporting long-term self-management. The focus is on empowering patients to take an active role in their recovery and regain control over their symptoms.
Treatment may include:
- Individualised graded exercise programmes
- Goal setting and activity pacing
- Pain education
- Hands-on therapy where appropriate
- Self-management strategies
- Improving strength, mobility, and function
- Supporting a gradual return to everyday activities and exercise
Every treatment plan is tailored to the individual’s needs, goals, and lifestyle.
Chartered Society of Physiotherapy Chronic Pain Guide
https://www.csp.org.uk/conditions/chronic-pain
Case Studies
Mrs A attended the physiotherapy clinic with persistent pain in her left hand and fingers following an injury two years previously. She presented with high levels of pain and significant restrictions in wrist and finger movement. Mrs A also reported a fear of moving
her arm and hand due to concerns that activity would worsen her pain, resulting in increased anxiety and reduced use of the affected limb.
Treatment focused on education, reassurance, and graded movement. She was prescribed gentle wrist and finger range-of-motion exercises, performed in warm water to help improve comfort and mobility.
Advice was also provided regarding the importance of gradual movement and exercise in managing persistent pain and restoring function.
Following four weeks of consistent exercise and ongoing support, Mrs A achieved near-full range of movement in her wrist and fingers. This led to a significant improvement in her ability to perform everyday activities and increased her confidence in managing her symptoms independently.
Outcome: Improved wrist and hand mobility, enhanced day-to-day function, reduced fear of movement, and greater confidence in self-managing persistent pain.
Ms D attended the physiotherapy clinic with longstanding pain affecting multiple joints due to osteoarthritis. Her mobility was significantly restricted, and during her initial assessment she reported low mood and frustration as she was struggling to complete even simple everyday tasks.
A key part of her assessment involved exploring what activities were most important to her and identifying meaningful goals. Ms D’s main aim was to return to swimming, an activity she had previously enjoyed but had stopped due to pain and reduced confidence in her mobility.
Together, we developed a gentle, graded exercise programme in the water that she felt comfortable and confident to begin. Treatment also included education on pain management, activity pacing, and strategies to gradually increase her activity levels without exacerbating her symptoms.
Following three treatment sessions, Ms D reported significant improvements in her overall mobility, confidence, and mental wellbeing. She developed a better understanding of her condition and gained confidence in managing her symptoms independently. Importantly, she recognised that experiencing some pain during activity did not necessarily indicate further damage and that regular movement and exercise were essential for maintaining strength, mobility, and function.
Outcome: Improved mobility and confidence, enhanced mental wellbeing, successful return to swimming, and greater understanding of self-management strategies for osteoarthritis.