«
»

Top

Physical therapy, chronic pain and chronic illness: our expert’s answers

Published 6 Sep 2019 • Updated 10 Aug 2020 • By Louise Bollecker

François Perrin is a physical therapist in Paris. He explains how his practise can help patients with chronic diseases to better manage pain and regain their functional capacities, especially to move better and find an adapted physical activity.

Physical therapy, chronic pain and chronic illness: our expert’s answers

Hello François, can you explain what physical therapy is all about?

Physical therapy is the treatment of physical and motor disabilities that result from injuries and diseases that can affect muscles, joints, bones, the neurological system (brain, nerves, spinal cord), the respiratory system (lungs), the circulatory system (blood vessels) and the heart system (heart).

Which chronic diseases can take advantage of this treatment?

There are many of them. Physical therapy is used in many medical specialities such as neurology (stroke, Parkinson's disease), traumatology, rheumatology, pulmonology, etc.

In rheumatology, for example, physical therapy is used as a long-term treatment for diseases such as MS, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis or Lyme disease.

This year, the theme of the World Physical Therapy Day is chronic pain. How can this discipline fight chronic pain?

Physical therapy uses analgesic techniques to relieve the patient suffering from chronic pain. This is the case, for example, with massage, electrotherapy or balneotherapy, which have a real immediate effect on pain. To reduce pain in a sustainable way, these methods are often combined with exercises and body mobilizations.

When you are in pain, it is difficult to be enthusiastic about doing exercises. What would you say to our readers who are in this situation?

Some patients are afraid of movement because they fear their pain will increase. But it’s the opposite: seeing a physical therapist will allow them to cross this barrier in a very gentle and progressive way. This is the only way to regain functional abilities. The vicious circle of "I'm in pain, I'm not moving" must be avoided at all costs. The solution is to be progressive in the intensity and repetition of the movements you achieve. I often say that the body adapts to what you ask of it! If you don't challenge your body, then you’ll get used to doing nothing and your body will lose its skills. On the contrary, when you use your body, it will always respond positively and allows functional capacities to improve.

To fight pain on a daily basis, what simple exercises would you recommend patients to do at home?

I cannot answer this question because it depends on the patient's pathology. But in general, it is important to do simple movements that respect the body physiology. The exercises must be easy to do, so that they are done properly, with no risk of hurting yourself, and so that the patient can repeat them daily with pleasure!

Is it important to be physically active between physical therapy sessions?

It’s the physical therapist’s job to help you choose the best physical activity. Sometimes, it is better not to be physically active between two sessions: for example, if you are in the inflammatory phase of osteoarthritis of the knee, it is obvious that it is not advisable to do a jog! On the other hand, other situations require to do sport between sessions: for example, if you are trying to get back in shape after an ankle sprain, it is important to complete the re-education with adapted sports sessions.

Are there any new techniques developing in the field of physical therapy?

Yes, physical therapy is really growing and learning. There are many scientific studies that are being carried out and the way we do our job is changing. Physical therapists have a duty of keeping up with these innovations and it allows us to be up to date on the treatments we offer to our patients.

If you suffer from inflammatory rheumatism such as rheumatoid arthritis, can you go to see your physical therapist when you are in an attack?

Of course! The physical therapist will use analgesic techniques to reduce the pain induced by this inflammatory phase.

The WCPT (World Confederation for Physical Therapy) explains that cancer patients can also benefit from physical therapy, can you tell us more?

I am not an expert of oncology, but I know that physical therapy’s results for some cancers are very encouraging. For example, in colon cancer, the physical activity allows a "gastric emptying", which prevents the growth of metastases as they no longer have the nutrients necessary for their development.

Beyond physical exercise, does the physical therapist have a role to play in accompanying and advising patients so that they can learn to better manage their pain?

It seems to me that this is a very important point.

I think it is essential for a patient with chronic pain to be managed by a health professional such as a physical therapist. The follow-up can be weekly or even daily depending on the pathology: the physical therapist gets to know the patient very well. I can adapt the sessions according to my patients' pain, as I know them and I know what they can cope with, what their state of mind is, etc.       

Are there any chronic pains or diseases for which the use of physical therapy is not recommended or not effective?

There are of course many pathologies for which it will not be useful. Always go to your GP for advice or to your specialist so they can tell you if physical therapy can do you good.

 

Have you ever tried physical therapy?
What have been the benefits of this practice on your mobility?

--

Meet our physical therapist expert

physical therapist

François Perrin is a masseur-physiotherapist in Paris. A former top-level sportsman, graduate of the Paris School of Physical Therapy (ADERF) and holder of a Master's degree in Sports Sciences (University of Paris Descartes V), François Perrin was trained at the Institut National du Sport (INSEP) and the Paris Saint Germain Training Centre (PSG) for several years. Specialized in sports traumatology, paediatrics (bronchiolitis), rheumatology, traumatology, neurology and pneumonia, he works in a multidisciplinary office that he shares with a general practitioner, a psychiatrist and a chiropractor.

Sources: know more about the World Confederation for Physical Therapy

avatar Louise Bollecker

Author: Louise Bollecker, Community Manager France

Community Manager of Carenity in France, Louise is also editor-in-chief of the Health Magazine to provide articles, videos and testimonials that focus on patients' experiences and making their voices heard. With a... >> Learn more

10 comments


lesmal • Ambassador
on 24/09/2019

I have lower back pain amongst many other ailments. I tried physiotherapy for at least 6 weeks some time ago. The pain was worse and I refused to carry on with it. I told the Physiotherapist that being on epilepsy medications for over 30 years together with HRT must have had an impact. I requested they send a report and suggested possible Osteoporosis.

Only then after the report was I sent for a DEXA scan and diagnosed with Osteopenia and Osteoporosis. In South Africa, my Physiotherapist did massage which made a big difference to back and hip pain, but they don't seem to do it here only physical exercise which is worse. 

I had surgery for a brain aneurysm last year and the only therapy I find useful is doing Code Search puzzles which relaxes the brain. I spend most of my time now on the laptop and find enjoyment doing social media and editing. 


David43
on 28/10/2019

It is all well talking about Physiotherapy, but where I live in Scotland I am told it is a 22 week waiting list on the NHS, so the only alternative is a Chiropracter.  I have trapped nerves in my spine confirmed by a MRI scan which makes me ache all over and I now think they were as a result of 3 failed epidurals for conditions prior to the removal of my Prostate which has also left me incontinent and on a  7 / 8 month waiting list for an artificial device.  


deniseann59
on 14/07/2020

@nineteen_gale I have had any disc trouble pain since I was in my 30s I'm now 60 mi e was u operable then now I got neve ending pain I think it may have somthink to do with my disc I'm in lot pain I have tried every think even phisio I'm in more pain I culdent do it Dr keeps giving me more stronger tablets they even had me on high dose of morphine and morphine tablet he had to hand me over to specialist they had to wearn me off slowly I didn't realize till I come off morphine I felt like zombie 🧟‍♂️ then he said I had fibroymelga and there was no medication fore it plus the nerve damage 


avatar
Unregistered member
on 14/07/2020

@deniseann59‍ 

Thank you for your message. you say you have nerve ending pain. I don't know your condition, but are you Diabetic? If you are, you can get Diabetic Neuropathy. Where ever possible, surgery should be the very last option. It is best to avoid it. Once operated on the spine, things are likely to go down hill from there. The disc above and then another one above, and that's how it goes on. Well, that is what happened to me. But in my case, the Sciatic nerve was jammed solid between the 2 discs, and could not be freed any other way. I suffered for 6 months with severe pins and needles down my leg, unbearable pain in my back, and I could neither sit, stand or walk. Lying down was the only way I could ease the pain. After that surgery the disc above the surgery collapsed one after another and I ended with Scoliosis and ended up having 4th and the 5th surgery to correct scoliosis. You said your problem was inoperable 30 years ago and you have managed another 30 years without the surgery. Can you get yourself referred to Brain and Spine Association? They support back problem people. Look them up on the internet. The are willing to chat with you, at least they were, when I contacted them 6 years ago. I don't know now. The beast thing to do is to chat with your GP and see if you could be referred to them. Good luck


deniseann59
on 14/07/2020

@deniseann59 hi no I'm diabetic, I'm borderline but I got trapped nerve in my neck and my left side back, my spine really painful some days, I suffer from breathing difficulties that's why they won't give me surgery because of the out come plus I'm over weight, now I'm waiting to see a specialist with my lungs as I had mild covid-19 last November and it's damage my left breathing sack so my breathing is very bad I'm on breathing tablets, nebuliser, plus inhalers, I could go on but don't want to bore you thank you for your answer Denise 

You will also like

How does changing time affect our health?

How does changing time affect our health?

Read the article
Light therapy: What is it and how can it benefit our health?

Light therapy: What is it and how can it benefit our health?

Read the article
What medications can cause hair loss?

What medications can cause hair loss?

Read the article
Which medications can cause adverse effects on the muscles?

Which medications can cause adverse effects on the muscles?

Read the article

Most commented discussions