The role of the physiotherapist in dealing with your persistent pain problems.
I am a chartered physiotherapist with a special interest in managing and treating pain problems that come from your bones, joints, nerves and muscles. Some GP’s have special interests but mostly they are experts in over-viewing all health issues, knowing all the potential diseases and what medicines might be used to treat them. Certain diseases and problems require a more specialised doctor or consultant and it is the role of the GP to refer you to the right one. However, the problem with medicine and specialist training is that there is little medical specialised training for ongoing pain from bones, joints, nerves and muscles.
When doctors want to become specialists, they generally focus on narrow bands of diseases or surgeries (e.g. rheumatologist, orthopaedic surgeon). From an assessment, which may include further investigations (x-rays, scans etc), the doctors or specialists are particularly good at looking for and identifying serious disease, and what medicines or surgeries might be effective for it. However, as doctors generally must be experts in over-viewing all health issues or specialists in a narrow band of medicine, I see them as experts at diseases and injuries, but not pain.
So, if you want help with ongoing pain, there are some physiotherapists who are trained with a special interest in pain. This includes the neurobiology of pain and how it applies to your experience. The knowledge and understanding from this can be greatly liberating for people suffering with ongoing pain. Especially if they have not got a specific reason from doctors for their ongoing pain, or possibly have many conflicting reasons from different healthcare professionals.
Physiotherapists are also trained in looking for things that you tell us and that we find with our physical examination that indicate something may be seriously wrong. These are called ‘Red flags’. If I find a ‘Red flag’ I will refer that person to a doctor for further investigations. Remember from above that doctors and consultants are experts in looking for and dealing with serious disease or injury.
Along with a greater understanding of your pain, the physiotherapist will be trained in fully assessing your physical function and capacity and explore ways of improving any deficiencies or weaknesses in a graded and incremental manner. With this approach, you will have greater knowledge of why you are in pain, what it means for you, and a plan of action to improve your quality of life based around what is important to you.
Alan Keane
