NDIS - Managing persistent pain successfully

The NDIS can be overwhelming. With so many providers offering so many services, where do you start?

We’re unpacking this for you, using a treatment focus approach that highlights some of the benefits of different

types of services that physiotherapists provide to people on the NDIS. 

Persistent Pain 

Persistent pain conditions are responsible for the 2nd largest burden of disability in Australia. Approximately 3.37 million Australians live with persistent pain that impacts every facet of their lives. 1.45 million also live with depression and anxiety. Of these individuals, 10 percent will have severe disability and dysfunction due to their chronic pain conditions. 

Persistent pain is complex and presents in a variety of ways.  While it can be present in isolation it is more commonly secondary to another disease process, injury or disability, such as arthritis, diabetes or fibromyalgia.   

Exercise for pain relief 

Most people when they have pain reach for medications – Paracetamol and anti-inflammatories. We’ve been indoctrinated to go to these as solutions for pain, largely ignoring the benefit of movement, exercise and graded loading. Pain-relieving medications can play a role in helping to manage pain, particularly in the short term. For longer term improvements though, we must incorporate movement, exercise and strengthening, to improve joint health, muscle strength, and function. 

Motion is Lotion 

In the physio world, we have a saying: “Motion is lotion”. The body loves to move, craves it, and depends on it for normal physiological function.  When we move, we increase blood flow to the working structures, bringing all sorts of goodies to the area to help oxygenate, lubricate and nourish. When movement is restricted, perhaps due to disease progression, trauma or surgery, our body adapts. Muscles get a little shorter and weaker, tendons get stiff, and our nerves become sensitised. All of this can result in persistent musculoskeletal pain.   

Now pain doesn’t necessarily mean that a structure is being damaged. Sometimes we experience pain because a structure, say a muscle, is just stiff and being moved beyond its CURRENT happy limit. That’s OK. If that muscle is gradually exposed to tolerable amounts of load, over time it will ADAPT to the new load, often improving its functionality and reducing pain. 

How to exercise and not “flare-up” 

It’s possibly the biggest fear for someone with persistent pain – the fear of being laid up for days on end with pain following an exercise session. 

When we’re talking about exercise in the context of persistent pain, we need a little more clarification. It’s not all about bicep curls, burpees and squats. Quite often it’s just gentle movements across gravity, stretches to the onset of tightness or nerve glides lying on your side. A new program might take 5 minutes a day to complete, while others might be longer. 

Exercises might be done in a pool or on land, indoors or outdoors. They might be done as part of a group or on your own. A lot of this is determined by YOUR preferences, and what works best for YOU.  All of this is super important. If you don’t like doing it, it makes you sore, and isn’t helping you to achieve your goals, then you are not going to persist with it. We know that if the person is engaged and empowered, the results (and therefore your happiness!) will be far superior. 

Getting the load just right – the rule of 10 

A little bit of exercise goes a long way, but it can be in the wrong direction if the type and volume prescribed is incorrect. Successful pain reduction with exercise dictates that the LOAD (ie. how much resistance or weight) and the VOLUME (how much you actually do) is spot on. 

The rule of 10 relies on the intensity of the effort versus the reported pain level is one method of achieving this. This method uses simple visual analogue scales to help the client determine the level of exercise intensity they should be performing AT THAT TIME. 

Let’s say you have a pain level of 6/10 while performing an exercise. We would then suggest that your perceived INTENSITY level be at a level of 4/10.  If tomorrow your pain is a little better, say a 3/10, push a little harder to a 7/10 intensity. Of course, this is just one method for guiding exercise. Physiotherapists use a variety of techniques to achieve the right load - hydrotherapy programs, pilates exercises, land-based programs and functional programs. 

Do you want to get more out of your NDIS funding?

Then give us a call.

All our clients are individually assessed and programs tailored to your specific goals. We are the only QIP Accredited Physiotherapy services in the Northern Territory and an approved NDIS provider. We offer a broad range of services to assist with management of persistent pain, including hydrotherapy, manual therapy, massage, graded exercise programs, clinical pilates and functional rehabilitation, all delivered by a highly skilled team.