Some types of pain therapies have been classified as rehabilitative
because they are performed or directed by physiatrists (physicians who
specialize in rehabilitation medicine) or by physical or occupational
therapists, or because they have the specific goal of improving function
as well as relieving pain. The injection therapies described above are
also commonly performed by physiatrists or other trained physicians and
could also be classified as a rehabilitative approach.
Physical therapy (PT)
PT can be an important part of the treatment strategy. PT
techniques are useful in teaching patients to control pain, to
move in safe and structurally correct ways, to improve range of
motion, and to increase flexibility, strength and endurance.
" Active" and "passive" modalities can both be used, but active
modalities, such as therapeutic exercise, are particularly important
when the goal is to improve both comfort and function.
Exercise
Exercise can have a variety of benefits. It has been
suggested that regular exercise could activate pain control
systems in the brain, possibly by affecting endorphin levels,
and also improve the functioning of the immune system (Jonsdottir, 2000)
(Goldfarb, 1997) (Vuori, 2001). Although these benefits are uncertain,
a very large clinical experience indicates that patients can benefit
from exercise in terms of better stamina and function. Exercise may
reduce the risk of secondary pain problems like muscle strains, and
may also lead to improved confidence and sense of well-being.
A supervised exercise regimen may include range of motion maneuvers,
strengthening techniques, and aerobic conditioning. Exercise programs
are particularly useful for chronic musculoskeletal pain including back,
neck and shoulder pain, rheumatoid and osteoarthritis pain and
fibromyalgia.
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