Physical Therapy for Chronic Pain

by Celeste Cooper, RN Health Professional

Do you live with chronic pain? I do, and according to the Institute of Medicine Report “Relieving Pain in America,” so do over 100 million other Americans. What you may not know is that a dysfunctional musculoskeletal system contributes to our pain. When muscles and other connective tissue are restrictive, joints fail to function properly. This not only causes pain in the muscle, it causes pain in the joint too because the joint is not properly aligned. A physical therapist that specializes in chronic pain can help us restore function and minimize pain.

Specialized physical therapists for treating chronic pain

The American Physical Therapy Association (APTA) says, “Physical therapists play an important role in managing chronic pain by administering treatments that include strengthening and flexibility exercises, manual therapy, posture awareness, and body mechanics instruction. Physical therapists can also help the patient to understand the underlying cause of their pain.”

Physical therapists are trained in kinesiology (the scientific study of human movement addressing physiological, mechanical, and psychological components), human anatomy, and physiology. Practitioners who treat chronic pain conditions have advanced training in things like dysfunction of the pelvic floor, the myofascia, long-standing sports injuries, and more.

Therapies you might expect

Physical therapists perform detailed physical exams and other assessments and make recommendations to our doctor or nurse practitioner based on their findings. They recognize that treatment approaches are different for chronic pain conditions than they are for acute injury or postoperative rehabilitation. Treatments they might recommend include:

  • Active release technique.

  • Low impact aerobic exercise – improves circulation and healing oxygen to our body while strengthening the heart and improving stamina.

  • Cryotherapy – ice used locally to reduce nerve transmission, inflammation, and pain.

  • Dry needling trigger point therapy.

  • Hydrotherapy – improving muscle function with minimal stress on our joints through water buoyancy.

  • Passive manual therapy – mobilizes joints and soft tissue.

  • Movement therapies – moving, exercising, and stretching to improve function of our lymph system and flexibility of joints and tissue.

  • Myofascial release.

  • Myofascial trigger point pressure.

  • Spray and stretch – a passive hands-on technique to release restrictions.

  • Strengthening – preventative maintenance once the myofascia and soft tissue are pliable and functioning without restrictions. Theraband, medicine balls, or light weights may be used to target a specific area depending and our progress in stabilization.

  • Stretches – maintains healthy muscle lengthening and improves flexibility.

  • Pulsed galvanic stimulation – providing high voltage electrical therapy to reduce muscle spasm and soft tissue swelling.

  • Transcutaneous electrical nerve stimulation (TENS) – providing low-voltage electrical therapy to manage chronic pain.

  • Ultrasound – provides deep heat and makes stretching easier.

  • Warm moist packs – relaxes muscles.

Integrative physical therapy clinics may include relaxation therapies, guided imagery, biofeedback, spinal manipulation, ergonomics, posture training, and more.

It’s important to note that there are therapies that can interfere with certain health conditions.


Our musculoskeletal system is meant to work in tandem and regardless of restrictions in connective tissue or muscle that are the result of disease, injury, surgery, or neglect. A dysfunctional system contributes to our pain and our function. A physical therapist who is trained to treat our specific condition and teaches us what we need to do to help ourselves with at-home therapies can provide hands-on and other therapies to recover function and reduce pain.

It’s important to interview physical therapists in our area to see if they provide chronic pain care, because not all physical therapists are specifically trained in the techniques we need. A referral from our physician and a discussion on how they will collaborate to bring about the best outcome is an important piece of integrative pain care.

Celeste Cooper, RN
Meet Our Writer
Celeste Cooper, RN

Celeste Cooper, R.N., is a freelance writer focusing on chronic pain and fibromyalgia. She is lead author of Integrative therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and the Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain book series. She enjoys her family, writing and advocating, photography, and nature. Connect with Celeste through Twitter @PainedInkSlayer.