Chronic Pain

Brief Overview:

• Chronic pain describes pain that has occurred for longer than 3 months 

• There may or may not be tissue damage associated with the pain symptoms

• See below some videos explaining chronic pain, some tips for working with clients who have chronic pain and some resources you may like to use  

Language Tips:

• The language we use with our clients has a HUGE IMPACT on how they feel about their pain 

Avoiding 'Fragile' Mindset:

• Avoid terms that may promote feelings of fragility or instability, e.g:

  • "be careful not to do too much"

  • "unstable..."

• Instead, try terms such as:

  • "lets build up how much you are doing based on how you are feeling"

  • "try doing the movement this way" 

Cueing:

• Avoid intrinsic cues , particularly for patients who overthink everything they are feeling , e.g. "brace your core" or "do you feel your SI joint"

• Instead, try extrinsic cues such as, "squat to this bench", "bring your chest to the box"
  

Some Pain Analogies/Education Points:

Twin Peaks Model:

• Tissue tolerance v. pain tolerance 

• https://www.tkex.org/blog/twinpeaks

Questions to discuss with your supervisor:

• How would conversations around an acute injury (e.g. regular client has come in and reports a sore ankle after rolling it this morning) vs a client with chronic pain (e.g. chronic ankle pain following a surgery 12 mo ago) during an exercise session?

• What education would be beneficial to provide regarding pain flare-ups?

• You are in an initial assessment. How might you educate your patient about potential DOMS, or that after a movement experiment they might actually feel worse? 

• What are some examples of interval cues vs external cues for a deadlift or push-up?

• In the chronic pain setting, are we focussing on curing this pain?