Non-Pharmaceutical Pain Relief

We are hearing more and more in the news about the “opiod crisis” across Canada and the great number of individuals affected by addiction to these drugs.  Canada is the second largest per capita user of prescription opioids in the world.  As a result, many Canadians are reluctant to take certain medications to manage their pain and physicians are also changing the way they manage pain.

Physiotherapists are primary health care providers who do not prescribe or administer drugs.  As such, we are well positioned and educated to help individuals with methods of pain relief that do not involve medication. 

Positioning and Ergonomics

As human beings we truly are “creatures of habit”.  We tend to walk a certain way, tilt our heads a certain way, lift a certain way without even realizing we are doing it.  In physiotherapy we refer to these ingrained habits as “movement patterns” and part of our job is teaching individuals to change movement patterns that could be contributing to their pain.  If your back hurts every time you walk more than 30 feet with your walker, a physiotherapist can be an objective set of eyes to assess how you are walking with it.  There is a good chance your walker may be too high or too low for your body, or perhaps you are standing too near or too far.  Often times, very simple changes can make a world of difference in preventing the pain from occurring in the first place.  A physiotherapist is like a pain detective who will take the time to talk with you about what causes your pain, how it behaves, what relieves it, etc. in order to help figure out what may be contributing to it and how best to change that. 

Modalities

A modality is something externally applied to the body for the purpose of pain relief or improvement of function.  Heat and ice are modalities that can decrease pain and promote healing by either increasing or decreasing blood flow to an area and having an effect on the nerves.  Heat is typically used for stiff, tight, painful areas and ice for hot and inflamed areas.  TENS machines are electrotherapy devices that work by stimulating the nerves with a specific electrical frequency to promote the release of your body’s natural pain killers (endorphins) and block pain signals into the spinal cord from an area.  Acupuncture is an ancient Chinese procedure involving inserting very fine needles into specific acupuncture points in the body with the purpose of stimulating your body’s natural pain killers, reducing inflammation and releasing tight musculature.  A physiotherapist can guide you in what modalities may be appropriate for you.

Manual therapy

Manual therapy refers to hands-on techniques performed by a physiotherapist typically with the purpose of improving joint mobility and releasing tight muscles and soft tissues.  This may involve massage techniques, stretching, and mobilizations to the joint that involve gentle pressure applied to the bones in certain directions. 

Exercise 

Exercise that is appropriate for your condition can promote pain relief in many different ways.  Stretching and range of motion exercise can reduce the stiffness in a joint or muscle resulting in less pain.  Movement promotes blood flow to our tissues, and that oxygen rich blood moving through tight tissues reduces pain.  Strength exercises can be beneficial to help take stress off of an arthritic joint or to improve posture which reduces the stress on the spine.  Cardiovascular exercise has been proven to cause an endorphin (natural pain killer) release from our brains.  A physiotherapist can guide you through exercises appropriate for body.

Medications certainly do have an important role in pain management, and often an individual may need a medication that helps with inflammation or nerve pain in order to get through their day and maintain their normal activity level. The above techniques can be used alone or alongside prescription pain medication; they are not a replacement for medication.  Physiotherapists are here as part of your health care team to offer guidance on how best to manage your pain with non-pharmaceutical measures to allow you to live your best life.