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Physiotherapy in Pain Medicine

The physiotherapist is primarily concerned with the examination of the locomotor apparatus and evaluation of the individual patient’s limitations in everyday life. A thorough evaluation of the problems is essential in order to determine and discuss the possible options and goals with the patient.
Improving the quality of life despite persisting chronic pain is often the primary goal of therapy. In each case, efforts can be made to increase the capacity for activity regardless of the duration of the painful disorder.

and Education – Understanding Pain
As a team member, the patient must understand how symptoms become chronic as well as the physiological mechanisms of his or her pain. This knowledge forms the basis for setting the course of therapy and following it successfully, and is essential in motivating behavioural changes and modulating the patient’s concept of illness.

Recognise and Utilise Resources
To ensure the active participation of the patient in his therapy, it is necessary to analyse and optimise his active and passive self-help strategies. The patient gains a sense of self-sufficiency and control over his pain, and can consequently deal with the pain problem more effectively and in a more active manner in everyday life.

Moving again – but how?
By gradually resuming and modifying everyday situations that had been avoided due to pain, the patient regains confidence in his body and its mobility. The patient’s positive ideas and feelings are supported and augmented during the course of therapy. Modern principles of treatment are based principally on cognitive-behavioural models, and are applied according to a physiotherapeutic viewpoint.
At the behavioural level, improved structuring of daily programmes and increased consciousness of tendencies for making excessive or insufficient demands on oneself form an important basis for achieving a healthy balance in everyday activities. The patient learns the principle of “pacing” (gradually increasing exertion) and its application by relevant, functional examples, which leads to improved stress tolerance and function in everyday life.