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Chronic Pain Physiotherapy
Chronic Pain Physiotherapy provides specialist pain science education, graded exercise therapy, and functional restoration for patients with persistent pain -- reducing pain disability, improving function, and supporting patients to reclaim active lives through the most evidence-based non-pharmacological approach available.
Overview
Chronic pain physiotherapy is based on contemporary pain neuroscience demonstrating that persistent pain is a complex biopsychosocial experience driven by central sensitisation, psychosocial contributors, and lifestyle factors rather than simply tissue damage. Pain neuroscience education -- explaining why the nervous system has become sensitised and how this drives pain -- dramatically reduces pain catastrophising, fear-avoidance, and disability when delivered effectively. Graded exposure to previously avoided activities, progressive exercise tolerance building, and active coping strategies address the behavioural and physical dimensions of chronic pain.
Chronic Pain Conditions Treated
- Chronic Low Back Pain (most common chronic pain presentation)
- Fibromyalgia and Central Sensitisation Syndrome
- Complex Regional Pain Syndrome (CRPS Type I and II)
- Chronic Widespread Pain
- Post-Surgical Persistent Pain
- Chronic Neck Pain and Cervicogenic Headache
- Chronic Shoulder, Hip, and Knee Pain with central sensitisation
- Occupational Chronic Pain and Work-Related Musculoskeletal Disorders
Chronic Pain Physiotherapy Interventions
- Pain Neuroscience Education (PNE -- reconceptualising pain as a neural system issue)
- Graded Activity and Graded Exposure (progressive return to feared activities)
- Acceptance and Commitment Therapy Principles (ACT-based physical rehabilitation)
- Pacing Strategies (boom-bust cycle breaking)
- Therapeutic Exercise (progressive aerobic and resistance exercise)
- Sleep Hygiene for Chronic Pain (addressing the pain-sleep relationship)
- Goal-Setting and Values-Based Activity (meaningful life participation)
- Multidisciplinary Pain Programme Coordination
Chronic Pain Physiotherapy Indications
- Persistent pain lasting more than 3 months not responding to standard treatments
- Significant functional disability from chronic pain affecting work and daily life
- Fear-avoidance behaviour preventing return to activities
- Pain disproportionate to tissue findings on imaging
- Fibromyalgia requiring multimodal rehabilitation
- CRPS requiring graded motor imagery and mirror therapy
- Post-surgical pain persisting beyond normal healing timeframes
- Chronic pain with significant psychological distress requiring biopsychosocial approach
Key Benefits
Discover the advantages of choosing our chronic pain physiotherapy services.
PNE reduces pain catastrophising and disability significantly before any exercise is undertaken
Graded exposure eliminates fear-avoidance disability -- often the largest component of chronic pain disability
Graded motor imagery achieves 50% or greater pain reduction in CRPS without any direct physical contact
Sleep optimisation reduces pain sensitisation providing clinically meaningful pain reduction
Active engagement with meaningful valued activities provides the most powerful long-term chronic pain management
Clinical Features
The technology, techniques and clinical approach behind our chronic pain physiotherapy.
Comprehensive biopsychosocial assessment including catastrophising fear-avoidance mood and sleep
PNE provided at first session as it independently reduces catastrophising before any exercise
Graded motor imagery for CRPS and phantom limb pain before progressing to real movement
Fear hierarchy developed for graded exposure targeting the most disabling avoidance behaviours
Return-to-work planning coordinated with employer and occupational health where relevant
Preparation Instructions
Consistently perform your home exercise programme between appointments -- physiotherapy works best when combined with regular independent practice. Report any significant worsening of pain or new symptoms to your physiotherapist promptly. Attend all scheduled sessions without missing appointments as momentum and progressive loading are central to physiotherapy outcomes. Communicate openly if any exercise is causing increased pain as the programme must be adjusted to remain within therapeutic parameters.
The Procedure
Step-by-step guide to what you can expect during your chronic pain physiotherapy procedure.
Comprehensive Pain Assessment
Pain characteristics (NRS pain quality distribution temporal patterns), catastrophising (PCS), disability (PDI), fear of movement (TSK), mood, sleep and physical function are assessed to create a complete biopsychosocial pain profile driving the individualised treatment plan.
Pain Neuroscience Education
Explanation of central sensitisation the concept that chronic pain reflects nervous system sensitisation rather than ongoing tissue damage fundamentally changes the patient's relationship with their pain and with movement. PNE independently reduces pain catastrophising and disability before any exercise is undertaken.
Graded Motor Imagery
Graded motor imagery (GMI) -- observation of movement laterality recognition and motor imagery -- retrains the brain's cortical representation of the painful body part. GMI is effective for CRPS phantom limb pain and some chronic limb pain conditions before progressing to real movement.
Graded Activity and Exposure
Graded activity increases physical activity tolerance through paced progressive exposure. Graded exposure specifically targets feared movements or activities -- using a fear hierarchy to systematically eliminate the fear-avoidance behaviours that perpetuate chronic pain disability.
Sleep and Lifestyle Optimisation
Sleep disruption amplifies central pain sensitisation. Sleep hygiene education relaxation techniques and CBT-based sleep strategies significantly reduce pain through improved sleep quality. Physical activity levels pacing strategies stress management and social engagement are all addressed.
Return to Activity and Work Planning
Functional goals specific to the patient's valued activities and roles are set at the outset. A structured graded return-to-work programme is coordinated with the employer and occupational health if relevant. Active engagement with meaningful activities is the most effective long-term chronic pain management strategy.
What to Expect
Your physiotherapist performs a detailed assessment of your movement, strength, posture, balance, and functional performance. The findings are explained clearly and a personalised physiotherapy programme is developed collaboratively. Each session includes hands-on treatment and supervised exercise. A home programme between sessions is provided as consistent practice between appointments is essential for progress.
Frequently Asked Questions
Common questions about chronic pain physiotherapy.
Related Services
Explore other services in our Physiotherapy department.
Musculoskeletal Physiotherapy
Neurological Rehabilitation
Post-Surgical Rehabilitation
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.
