Acute and Persistent Pain Management
Osteopathic Approach to Acute and ‘Chronic’ Pain: An Evidence-Based Perspective
Understanding Acute and Chronic Pain
Pain is an experience that can vary significantly from person to person, and it’s often misunderstood. In the simplest terms, acute pain is pain that comes on suddenly and is usually tied to a specific injury or illness. It’s your body’s immediate response to tissue damage or injury, such as a sprained ankle, muscle strain, or a fracture. Acute pain usually lasts a few days to a few weeks and resolves as the underlying injury or condition heals.
In contrast, chronic pain (now more accurately referred to as persistent pain) is pain that persists for longer than three months, well beyond the usual healing time of an injury or illness. Persistent pain can arise from an initial injury or health condition, or it may have no clear cause at all. It’s not just about physical sensations; persistent pain can affect emotional well-being, sleep, mobility, and overall quality of life. Conditions like osteoarthritis, fibromyalgia, and low back pain are common causes of persistent pain.
Importantly, acute and persistent pain are not entirely separate. Acute pain that isn’t properly managed can develop into persistent pain, particularly if there is persistent inflammation, nerve sensitization, or psychological factors like fear or anxiety that exacerbate the pain experience.
The Osteopathic Approach to Pain Management
Osteopaths, including myself, take a holistic and evidence-based approach to pain management. This means looking beyond just the site of pain to understand the underlying causes and contributors to the condition. Whether you’re dealing with acute or chronic pain, an osteopathic examination and treatment plan are designed to be individualised and patient-centred, addressing the specific needs of each person.
Evidence-Based Assessment of Acute and Persistent Pain
The first step in managing pain is a thorough clinical assessment. This typically includes:
Patient History: Understanding the onset, nature, and duration of your pain, along with any potential triggers or aggravating factors.
Physical Examination: I will assess not only the painful area but also related regions that may be contributing to the problem. For acute injuries, this often includes checking for signs of tissue damage, inflammation, and mobility restrictions. For chronic pain, a broader evaluation of various systems of the body, movement patterns, and joint function is necessary.
Functional Impact: I’ll discuss with you how your pain is affecting your daily life—whether it’s limiting your ability to move, sleep, or perform regular activities. Understanding this helps guide an effective, personalized treatment plan.
Psychosocial Considerations: Particularly for chronic pain, we look at how emotional, psychological, and social factors might be influencing your pain. Stress, anxiety, or depression can play a large role in amplifying pain, so these need to be part of the assessment.
By using validated pain assessment tools and current clinical guidelines, I ensure that the evaluation process is comprehensive and aligned with the best evidence.
Osteopathic Management of Acute Pain
For acute pain, the aim is typically pain relief, reducing inflammation, and supporting tissue healing. Common acute pain conditions that I manage include:
Muscle strains and sprains
Tendonitis
Ligament injuries (e.g., sprained ankle, ACL injuries)
Acute back and neck pain
Post-surgical pain (early-stage recovery)
Osteopathic Techniques in Acute Pain
Soft Tissue Techniques: These aim to reduce muscle tension and reduce sensations of stiffness and pain.
Joint Mobilization: Gentle movement of joints can help restore mobility and reduce stiffness without aggravating the pain.
Pain Education: Acute pain can cause fear of movement, which can delay recovery. I provide reassurance and guidance on safe ways to move and exercise during recovery to facilitate faster healing.
Exercise Prescription: Targeted rehabilitation exercises are provided to restore strength, flexibility, and range of motion. These exercises are designed to prevent further injury and support recovery.
Evidence-Based Support for Acute Pain: Research suggests that manual therapy (such as osteopathy) combined with exercise can help speed recovery from acute musculoskeletal injuries. Early intervention, when safe to do so, helps prevent the transition of acute pain into chronic pain.
Osteopathic Management of Chronic Pain
Chronic pain is a more complex condition, often requiring a multidisciplinary approach. Conditions like osteoarthritis, fibromyalgia, or persistent low back pain can benefit from the long-term support provided by an osteopath.
Osteopathic Techniques in Chronic Pain
Myofascial Release: Targeted techniques to reduce tension in the soft tissues surrounding muscles and joints, often providing significant relief in chronic pain conditions.
Joint Mobilization and Manipulation: Gentle techniques to improve joint mobility and reduce stiffness, particularly in conditions like osteoarthritis or chronic lower back pain.
Pain Desensitization: Chronic pain often involves sensitized nerve pathways. Osteopathic treatment can help reduce this sensitivity through a combination of manual therapy, education, and graded movement.
Movement Retraining: For those with chronic pain, patterns of movement can become altered as the body compensates for pain. Re-educating these movement patterns is crucial for long-term management.
Education: Chronic pain is complex, and understanding how it works is a key part of managing it. I’ll work with you to demystify chronic pain, offering evidence-based education on the nervous system's role in amplifying pain and how we can counteract these effects with movement, manual therapy, and lifestyle changes.
Evidence-Based Support for Chronic Pain: Manual therapies, including those used by osteopaths, have been shown to reduce pain intensity, improve function, and enhance the quality of life for individuals with chronic pain. Exercise therapy and pain education also play a crucial role in managing chronic pain and are consistently recommended in clinical guidelines.
Collaboration with Other Health Care Providers
While osteopathic care is highly effective in managing both acute and persistent pain, a multidisciplinary approach is often the best way to provide comprehensive care. I work closely with other healthcare providers to ensure that your treatment plan is well-rounded and meets your specific needs. This may include:
General Practitioners (GPs): For medical evaluation and, where appropriate, medication management.
Physiotherapists: Particularly for rehabilitation post-injury or surgery, where a physiotherapy-focused exercise program complements osteopathic care.
Pain Specialists: In cases of severe or complex persistent pain, I may collaborate with pain specialists who can provide additional medical interventions, such as injections or nerve blocks, while I focus on manual therapy and functional rehabilitation.
Psychologists or Counsellors: Persistent pain can have significant mental health impacts. Referral to a psychologist for cognitive-behavioural therapy (CBT) or other pain management techniques may be part of a well-rounded approach to care.
Surgeons or Orthopedic Specialists: For post-surgical rehabilitation, osteopathic care can help restore function and reduce pain in conjunction with surgical follow-up.
How I Can Help You?
As an evidence-based osteopath, my goal is to help you manage your pain in the most effective, safe, and holistic way possible. Whether you’re dealing with acute pain from a recent injury or persistent pain that has lasted for months-years, my approach will be centred around your needs and goals. You’ll receive a tailored treatment plan, combining the best available evidence with osteopathic techniques to reduce pain, restore function, and improve your quality of life.
If you’re struggling with pain, whether acute or persistent, and are looking for a safe, effective, and natural approach, I can help guide you through your recovery and offer support every step of the way. Don't hesitate to reach out and begin your journey towards a less painful life.