At the Evolve Wellness Centre Byron Bay our Physiotherapy Clinic specialises in complex And chronic pain Issues. Using a comprehensive and integrated approach we regard ourselves to regularly help clients navigate through chronic pain where previous treatments have failed. We do this by implementing our unique Chronic Pain Solution Program that utilises assessment and treatment methods that seek to find and treat the cause of your issue and not just manage the symptoms.
Let’s take a closer look at Chronic pain and what we can do to help.
What is Chronic Pain?
By most medical definitions, pain is regarded as chronic when it does not go away and is experienced by a person on most days of the week for at least 3 months. Chronic pain can have an enormous impact on its sufferers and it may interfere with a person’s sleep patterns, ability to work, sexual activity, and conduct of daily activities. It may also be the primary cause of headaches including migraine, tension and cluster headaches. Furthermore, it can cause emotional distress and lead to serious mental health problems, including depression. You can experience chronic pain in any part of your body but in the Physiotherapy Clinic headache, peripheral joint, neck and back pain would be the most common areas of complaint.
Some Chronic Pain Facts:
- About 1 in 5 Australians suffer a form of from chronic pain.
- Prevalence tends to be higher in older individuals.
- The leading cause of chronic pain is reported to be injury commonly stemming from playing sport, car accidents, home accidents and work accidents.
- Almost two-thirds of people with chronic pain report that their pain interferes with their daily activities.
What Causes Chronic Pain?
While acute (short term) pain can usually be attributed to an identifiable disease or damaged process, finding an identifiable process for chronic pain can be very difficult. The cause of pain is not always easily determined and it may even stem from a repetitive movement pattern, longstanding weakness or poor postural habits having a compounding effect over time or injuries that occurred many years ago. This does not make the pain any less real or relevant. As you are getting older, you may also be finding an old injury coming back. This can be due to the underlying problem never being found or appropriately treated. We also have to consider the emotional components of pain which have an impact.
At Evolve our Physiotherapists have done extra training in recognized methods with proven success for treating chronic pain conditions, namely ‘Clinical Pilates’ and the ‘Connect Therapy’ treatment method. Using these methods combined with our own experience we have developed a Chronic Pain Solution Program that is a natural rehabilitation program for people seeking optimal outcomes with:
- Recovery of an old injury that failed to heal
- Effective relief from ‘Fibromyalgia’ type symptoms
- People seeking to avoid an orthopaedic surgical procedure or postpone, prepare and recover from ‘failed’ joint replacement or spinal surgery.
Conventional Physio research has advocated that the longer a client has been suffering the more treatment should move towards general exercise programs. At Evolve however we found it’s treating with more specificity to be key for our successful outcomes. The goals of our treatments are always to enhance function first while minimising the risk of adverse effects. This is why when participating in a Chronic Pain Solution Program at Evolve it is important to avoid focussing on your pain and not to worry about further damage as in the highly controlled environment there is minimal chance of doing such. In the early stages you may have fluctuating symptoms and your pain may or may not change significantly. Usually, this is only temporary and longer periods of relief will become more normal as uncontrolled muscles learn to function better. These functional improvements will often be a result of improved alignment and more efficient neutral recruitment of the muscles surrounding the affected area i.e. improved muscle control. The result is a joint or spine that works more efficiently from improved functional stability. This improvement in recruitment of muscle groups and stability allows a chronically overstressed joint to function effectively and gives the surrounding structures the chance to heal. That is why we use function as a key initial indicator for improvement when participating in a our program.
Expected Time Frames For Healing
General Cellular healing in humans can take 6-8 weeks and this is still the case for chronic issues however as explained the reason for the pain has to be identified and improved first before the cellular healing has a chance to start. This can take 3-4 weeks so you can expect about 3 months of following the program to completion to see a significant reduction in your pain. If good improvements can be seen over the first 6 week period of the program (monitored with video testing, and detailed outcome measures), then the initial functional problems that were thought to be due to joint degeneration or specific pathology are no longer justifiable and in some cases orthopaedic surgery can be avoided and/or surgical outcome optimised.
The Chronic Pain Solution Program Design:
The Program is split into 3 stages, each having their own phases of action. The first stage is approximately 4 weeks, during which time clients will undergo a specific screening and treatments consisting mostly of soft tissue release, spinal/joint adjustments and introduction of stabilisation exercises. The program will include a multitude of approaches along with Clinical Pilates which has been increasingly proven to assist with recovery from chronic injury (interview with Scott Thomson on Clinical Pilates). Measurement assessments are repeated weekly for outcome data including the use of ‘Advice Rehab’ technology that will contribute to a comprehensive report at the end of each stage with progress graphs and recommendations to help decide what action needs to be taken next. In Stage two we progress our clients to group classes as this allows us to help more people with more time and makes it more cost effective for our clients.
If a program has been followed correctly to completion and we are not satisfied with the outcome then we do not give up but instead must consider the next step of management. In some cases that can mean surgery but at the very least a client will emerge from a program with a better understanding of their body and improved movement patterns and functional stability.
Below is a brief summary of what you can expect:
Stage One (4 weeks): 5-6 x Physio 1:1 session
Stage Two (4 weeks): 8 x Group Clinical Pilates/week (2 x week) and 2 x Physio 1:1 sessions (2nd and 4th week).
Stage Three (4-6 weeks): Cont with Clinical Pilates Classes, home exercise and Physio review session.
Medicare Chronic Pain Management
All of our treatments and Pilates classes are claimable through private health funds however with the monthly cost of health funds getting more expensive we have noticed more people choosing not to be covered. Good news is people with a chronic medical condition are eligible for Medicare benefits to cover some Physiotherapy costs that help manage their condition. This cover can be particularly important for getting through the stage one of the program as financially it is the most expensive. To be eligible for the benefits, your doctor needs to provide you with a Chronic Disease Management Plan (formerly EPC Plan). This is a plan of action agreed between you and your GP and it identifies your health care needs, sets out the services to be provided and lists the actions that you need to take. You will have to specify the physiotherapist to provide treatment and provided they don’t want to send you to another healthcare service, you should get 5 Physiotherapy treatments a year with a rebate of $52.95 for each session. Contact us or your doctor to find out more about chronic disease management plans.
We hope this has helped increase your understanding of Chronic pain and how it needs to be managed. Some final words of advice from us if you consider to start the program:
- Don’t ever give up hope. The mind is also a powerful tool for healing and this is something we will explain in more detail later and during a program.
- You must be willing. As therapist we can only guide and navigate you through the healing process. It is only through your own willingness and effort that it’s possible to get yourself out of Chronic Pain issues.
- Let go of the past. However you came into your current situation has to be let go as holding onto resentment and blame will not help you heal and recover and can actually hinder the process. If this does not come naturally to you is a skill that can be taught and improved.
- Don’t focus on the pain. We have explained above the importance of this but it cannot be emphasised enough. If a client can’t do this then their chances of success are greatly reduced and relapse and program dropout high. This leads to the next point..
- You must stay committed to the end. Because we are trying to reverse movement patterns and behaviours that most likely have been occurring for years, relapses are very common especially when clients don’t commit with the program to completion or take a couple (or more) weeks off. We understand life gets busy but this is where priority needs to ordered correctly. Fortunately people who are in longstanding pain will take their management more seriously, prioritise their home exercise and attendance of classes and commit to the advice above. Poor commitment and holding onto scepticism will only leave you and your therapist frustrated.
To get involved or for more information contact us on 0416 749 746 or 0416PHYSIO