Movement, exercise and exercise therapies, regardless of their form, are recommended in the management of patients with chronic pain.
Most patients with chronic pain are physically deconditioned from inactivity.89 There is strong evidence that normalisation of activity, as far as possible, is associated with reduction in the level of pain and improvement in function and wellbeing of patients with CNCP,22,89,227 including low back pain,82,228 osteoarthritis of the knee83 and hip,84 and fibromyalgia.85 With low back pain, staying active is associated with less pain intensity,229 improved function230 and reduced disability in the long term.86 Pilates has low-quality and inconsistent evidence of effectiveness in improving chronic low back pain.231,232
The Royal Australian College of Physicians (RACP),233 the RACGP and other bodies recommend that returning to work (where possible and appropriate) has substantial benefits in improving patient morbidity and wellbeing.233,234
Australian physiotherapists play a critical role in assisting the management of chronic pain. They are familiar with the biopsychosocial approach to pain and work across all age groups in primary care settings. Physiotherapists provide a range of evidence-based care, designed with the aim of diminishing pain and improving quality of life, to rehabilitate and improve movement.
The effectiveness of physiotherapy will be dependent on the nature and range of physical intervention strategies used and what conditions are treated.50,230,231,235–241 For example, there is no high-quality evidence to support the use of ultrasound for improving pain or quality of life in patients with non-specific chronic low back pain.242 There is low to moderate effectiveness of exercise, psychological therapies, multidisciplinary rehabilitation, and massage for chronic low back pain.230,231,235
Find a physiotherapist
The Australian Physiotherapy Association website has a Find a Physio facility to assist access to physiotherapists who have enhanced training in pain management.