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Chronic Pain is a complex interaction between the body’s physiological processes and the brains hard wiring system. Chronic pain often leaves people feeling like they have a cloud hanging over them with constant nagging and debilitating symptoms. There are many different strategies involved with managing chronic pain but the best approach is one with a multidisciplinary team. It is important to have a collection of people around you, including doctors, physiotherapists, pain specialists etc that are all working together telling you the same thing.

Generally the body is very good at healing itself; however, this can come unstuck, maybe in the form of chronic overload of tissues, from nerve injuries, or from poor and altered healing responses from your body. Often these changes have occurred over a prolonged period of time which indicates that a sustained period of physiotherapy and rehabilitation needs to occur to address all the underlying pathological tissues changes.

Chronic pain will lead to tissues in your body becoming extremely deconditioned and this can lead to a vicious circle of boom and bust cycles, the danger lies in overdoing it when you are feeling good leading to a vicious flare up of pain after which you then need to take further rest cycles and delaying your rehabilitation. The best approach to chronic pain is to try and address the underlying pathological tissue changes that have occurred, using techniques such as massage, acupuncture or mobilisation, combine with a graduated exercise program to reprogram your neural system and local muscles. These then need to be developed to increase your strength and endurance so that your body learns to adapt to the daily stresses of life and work and improves ones endurance capacity.

Cardiovascular exercise forms an important part of this regime and will be vital to improving the condition of your tissues so that your tissue tolerance to loading improves. This takes place with exercise bike work or a hydrotherapy program and can be seen as an important way to help rebuild your fitness levels. It will take a large amount of effort and work but with the appropriate attention and desire you can change your situation. Ensuring that you work hard with your specific program to gradually increase your exercise levels without flare ups is very important.

Pacing is an important component of the program that needs to be discussed with your physiotherapist. It is important to be gradually increasing what you are doing by no more than 5- 10 percent per week. Your body then slowly adapts to these stresses getting stronger without risking being overloaded too rapidly.

There is no magic recipe with chronic pain but a specific program designed for the individual that incorporates a specific exercise and rehabilitation program will ensure you improve your situation and help to manage your pain levels more effectively.