Chronic Pain Takes Time

I’ve been doing coaching sessions with my dad for about 15 months.  We started because he had pain in his right shoulder which troubled him particularly when he lifted his arm overhead.  He received some steroid injections but they didn’t seem to have the long term effect he was hoping for.  After a few months of discomfort and limitation, Dad’s condition was now considered chronic, and I convinced him to start sessions with me.

We saw each other once a week, sometimes every other, for 30-45minutes.  It took him about 8 months to feel like he was really gaining mobility, able to do everyday things like reach off the top shelf without pain, and do his routine upper body exercises at the gym without exacerbated pain the following day.

Considering we only saw each other a few times a month and for short sessions, 8 months was actually great progress.  Not all cases are the same and there are chronic cases that don’t take quite as long.  However there are just as many that take longer.  Might his pain have cleared up sooner had we been seeing each other more often? It’s likely, but not certain. Sometimes things just take time.

This matters because the average physical therapy prescription for chronic pain is 6 to 8 weeks, only up to 12 weeks with more severe cases.  It took my dad 32 weeks.  We all want to see things get better within the first couple of sessions of trying a new therapy or treatment, whatever that may be.  Sometimes things work that way, but when pain becomes chronic, there are a lot of barriers to break down in the rehab process.  There are physical barriers like loss of strength, loss of proprioception, compensatory patterns, and inflammation.  But there are also belief systems, movement associations, and nervous system sensitivities that develop over the chronicity of the pain —all of which may take a while to break down.  While this might not be what you want to hear, my purpose is to actually give you hope.  If you’ve been in and out of physical therapy over the years with pain coming and going in the same spot without much progress, it doesn’t mean your body is failing you! It doesn’t mean you have to surrender to life-long physical limitations, surgery, or the idea of “old age.”  The message this month is short and simple.  Chronic pain is more complex than just an injury to the tissues and working through those layers can take time. That time requires one to have a long term outlook, consistency, and patience.

Keep moving.