Chronic pain is a burden no one should live with. Yet more than 1 in 5 adults in the U.S. have an ailment or injury that causes them to feel pain almost every day. For many, the pain is debilitating enough to interfere with their daily activities or work life.

If you or a loved one suffers from chronic pain, you may be trying or considering different ways to find relief, such as medications, injections, or even surgery. But have you ever thought about physical therapy? If you’re looking for a safe alternative to manage your pain, seeing a physical therapist could be a good place to start.

The advantages physical therapy can offer

Physical therapists are movement experts who use prescribed exercise, hands-on care, and education to improve mobility, reduce or manage pain, restore function, and prevent re-injury or disability. There are different types of physical therapy (PT), and attending some weekly sessions can offer several advantages in treating chronic pain.

  • The program is customized for you. PT can be tailored to address your specific condition and biomechanical issues, explains Summit Health physician Ashley Michael, MD, a physical medicine and rehabilitation specialist who specializes in the nonoperative treatment of sports and spine injuries. Biomechanics is how your bones, muscles, ligaments, tendons, blood circulation, and other bodily functions work together to allow for movement.

Dr. Michael highlights that “With a 30- or 60-minute session, physical therapists can learn about your symptoms, stressors, and lifestyle to design an individualized home exercise plan.”

  • PT can reduce the need for pain medication and invasive procedures. Many chronic pain sufferers turn to anti-inflammatory medications such as ibuprofen, opioids, or other over-the-counter and prescription medications for relief. Unfortunately, these drugs may pose risks, including organ damage with long-term use or overuse, addiction, overdose, and withdrawal symptoms.

“Patients often complain about the number of medications they are taking,” says Dr. Michael. “PT and diligent home exercises can help patients actually address the problem and sometimes avoid the use of medications altogether.”

Some people receive cortisone (corticosteroid) shots or other interventional procedures to manage their chronic pain. “PT can also help patients get the most out of the procedures we perform and sometimes eliminate the need for future injections or procedures,” says Dr. Michael.

Repeated cortisone injections can also cause a gradual deterioration of joints and tendons, Dr. Michael adds. “PT offers a non-invasive alternative to these interventions.”

  • An individualized plan will put you in better control of your pain and overall health. PT can make you stronger, help you move better, and allow you to feel more in control of your pain. “PT has the potential to improve patients’ function and empower them with a sense of ownership over their condition,” says Dr. Michael. Increasing your physical activity can also benefit your long-term health by improving your mood and sleep and reducing your risk of developing many chronic diseases.

Chronic conditions physical therapy can treat

Dr. Michael also says that the majority of painful conditions can benefit from PT. “In many cases, it’s a good idea for patients to try PT before medication, injections, or surgery,” she advises. Some of the most common conditions treated include:

  • Arthritis
  • Back pain
  • Neck pain
  • Headaches
  • Fibromyalgia
  • Complex regional pain syndrome
  • Myofascial pain syndrome
  • Neuropathic pain

She also notes that imaging may not always be a necessary step to getting better. “In some cases, what shows up on scans is not the source of the patient’s pain,” she adds. “While imaging is a helpful tool, it is important to treat patients and their symptoms, not just a picture.  My medical team and the patient’s physical therapist can adapt treatments and guide care based on how they progress.”

Types of physical therapy treatments

A physical therapist will develop your treatment plan based on your age, diagnosis, level of pain, and other medical or musculoskeletal conditions. Your treatment plan may include a mix of:

  • Low-impact aerobic exercise, such as walking or riding a stationary bike
  • Strength exercises using weights, resistance bands, or your body weight, often targeting your problem area and the muscles surrounding it
  • Stretching to lengthen tight muscles
  • Manual, or hands-on, therapies to ease pain, relax the muscles, and improve range of motion, including:
    • Massage and myofascial release
    • Joint and soft tissue mobilization
    • Muscle energy technique
    • Manual traction
    • Strain counterstrain manual therapy
    • Taping
  • Neuromuscular education, which retrains the body to perform controlled movement, balance, coordination, and posture
  • Focused work on posture, ergonomics, and gait to address any bad habits formed over time

Your therapist may also use various modalities to reduce pain. These include:

  • Electrical stimulation such as TENS (transcutaneous electrical neuromuscular stimulation)
  • Light therapy
  • Ultrasound
  • Shockwave therapy

Dr. Michael says education is a core component of understanding pain.  In PT patients learn what is going on in the body and how to adapt.   “With chronic pain, the body’s ‘alarm system’ can become uncalibrated. Learning about your pain and how pain works can help you better manage your symptoms and improve both your activity level and function.”

What to expect with physical therapy

During your first PT visit, your therapist will ask about your symptoms and perform an exam to make a diagnosis. Your therapist also will take the important step of discussing your goals as part of developing your treatment plan.

Dr. Michael asks her patients what activities chronic pain prevents them from participating in and what they want to be able to comfortably do again. “Knowing a patient’s goals goes a long way in setting up a comprehensive plan that will help you comfortably return to the activities you enjoy. We partner with you and your other healthcare providers to make the process as seamless and effective as possible,” she adds.

Some PT exercises may be challenging, and you may feel sore afterward. But this can be an expected part of healing and growing stronger. Communication is the key to progress

The number of PT sessions you need will depend on your condition, how long you’ve been having symptoms, and your goals. Your therapist will help you set realistic expectations, understanding that everyone responds differently to PT.

PT may not eliminate your chronic pain entirely, but it can be a safe and beneficial step toward better quality of life. The goal is for you to spend less time focused on pain and more on the things you enjoy doing.