Pain Rehabilitation
What is rehabilitation?
Rehabilitation Medicine is the medical specialty focused on optimising function, independence and quality of life when illness, injury or disease affects a person’s ability to participate in everyday activities, work or recreation.
Rehabilitation Medicine Physicians (also known as physiatrists) are specialist doctors who assess, diagnose and manage the consequences of illness, injury and disability using the principles, knowledge and evidence base of rehabilitation medicine.
The three circles represent the three core components of rehabilitation treatment – education, exercise and strategies.
What is pain rehabilitation?
Put simply, pain rehabilitation is rehabilitation for people whose pain has persisted longer than expected.
Everyone experiences pain. However, when pain persists, it can affect mobility, confidence, independence, work, recreation and quality of life. Persistent pain is one of the leading causes of disability worldwide.
Conditions such as knee osteoarthritis, low back pain and persistent pain after surgery are among the most common causes.
Persistent pain is complex and is rarely explained by a single factor. For this reason, rehabilitation usually involves a combination of approaches rather than relying on a single treatment.
Pain rehabilitation focuses not only on reducing pain, but also on understanding why pain persists, improving function and supporting participation in work, recreation and everyday life.
Rehabilitation may include education, exercise, movement retraining, self-management strategies, sleep optimisation, psychological approaches and other evidence-based interventions tailored to an individual’s needs.
Why does pain persist?
To understand why pain persists requires an understanding of why we have pain.
Why do we experience pain?
Most adults have learned to associate pain with an injury – that is, that pain means our body is damaged.
And this can be true. Pain can alert us to an injury, like a broken bone.
But pain has another meaning.
Pain also helps us detect danger – a risk of injury to our body.
So pain arises when we detect a threat to our body – a risk of injury (danger) or actual injury (damage).
What is the role of pain?
Pain is a threat detection system – why?
So that we can be protected from being harmed or take action to minimise the harm.
Pain serves to detect and protect.
Does everyone experience pain the same?
They do not.
For example:
- 50% of people with knee osteoarthritis have pain and 50% do not.
- 50% of people continue to experience pain 12 months after a knee replacement and 50% do not.
- people with changes to their backs on scans (such as disc prolapse, facet joint disease and degenerative changes) have equal chances of having pain or being pain free.
- Only 15% of people with spinal canal stenosis have pain.
Why is pain experienced differently?
Pain is a real experience. It is not made up or “all in the head”.
Pain is not about being weak or hopeless.
Pain is about changes to the body’s structures like joints and muscles and discs.
But it is also about how our central nervous system (our spinal cord and brain) interprets it.
Some pain detection systems are very sensitive and see danger everywhere.
Some pain detection systems are very sensitive to a particular area of the body.
Some pain systems are less sensitive and don’t see danger in that area of the body.
The consequences of pain
For some people with persistent pain, they report that their pain does not bother them.
For others, pain can lead to protective movement patterns such as limping, a reduction in exercise, a reduction in activity, less work, less recreation and reduced quality of life.
Pain can also lead to sleep dysfunction, loss of motivation, fatigue, brain fog, reduced mood and more anxiety.
Changing the pain experience
Pain rehabilitation aims to develop your understanding of our pain so that you can change the experience.
If you have the curiosity, our programs teach you what you need to know to make sense of your pain.
Once you understand your pain, you can make choices about what you need to do to recover.
Our programs teach you how to retrain your mind and body to reduce pain and return to enjoyable activities and a meaningful life.
When is pain rehabilitation useful?
Pain rehabilitation is useful when:
- pain has persisted for more than 3 months
- recovery has stalled despite appropriate treatment
- pain is limiting movement, enjoyable activities, independence or participation in everyday life
Pain rehabilitation is for people:
- who want to better understand their pain and recovery
- who are interested in why pain persists
- who want to learn practical skills and strategies to better manage their pain and improve function
Our pain rehabilitation programs are:
- Kneed: an online program for persistent pain after knee replacement
- Spined: an online program for persistent back pain and persistent pain after back surgery.
Kneed
Learn more about why pain persists after a knee replacement
Spined
Learn more about back pain and why pain persists after back surgery
