Chronic Pain – Active versus Passive Treatment

Simon West (Exercise Physiologist – Burnie)

• Are you wondering if you are heading down the right path with you pain treatment?
• Do you feel like something has been missed or you are desparate to just try anything?
• Are you frustrated with the economic impact of being a person with chronic pain?

The cost of chronic pain to the community, individually and as a group is significant as 68% of people managing chronic pain are within the working age group. This is further expected to increase by 2050 according to Deloitte economics affecting an increased number of people from 3.24 million to 5.3 million in this timeframe.

Treatment costs to the individual can range from costly options such as surgical interventions and scanning to no cost at all with strategies such as regular walking or mindfullness. To categorise treatment options for chronic pain we can simplify treatment styles into one of two categories: active treatment or passive treament. But what does this mean? Is one better than the other?

Passive treatent can be viewed as treatments that don’t require you to be an active participant of the treatment but rather a passive recipiant where something is given to you to take or someone is doing something to you. For the purposre of this discussion, let’s call these treatment tools in the treatment of pain. Passive treatments are very useful in the acute and sub-acute phase of injury. These treatments might include but are not limited to:

• Surgery
• Medication
• Massage
• Accupuncture
• Manipulations
• Rest

Active strategies, on the other hand, require a little more effort on the pain patient’s behalf. These tools are very useful at any stage (acute or chronic) of the pain rehabilitation process. These tools might include but are not limited to:

• Pain education
• Re-engaging with physical activity
• Cognitive reframing of pain (changing the meaning of the pain)
• Planning
• Goal setting
• Mindfulness
• Healthy eating strategies
• Healthy sleep strategies

Once any red flags have been ruled out, and all reasonable treatment has been explored, the ongoing pursuit of short term symptomatic treatment, through passive treatments or a search for a quick fix, may be met with more frustration and an increasing financial cost.

With regard to the appropriate management of chronic pain, our Physiotherapists and Exercise Physiologists at Coastal Physiotherapy have engaged in further traing and education in the management of ongoing pain issues. Whist passive treatments may be indicated to help on some occations, our staff in Burnie and Somerset will ensure that you remain at the centre of your pain management experience by ensuring that you are provided with the best active strategies to regain in control of your pain. While all of the active strategies mentioned previously will be encouraged, validating your pain experience, pain education and a plan to move forward, remain the key strategies to improve your function and minimise the impact of pain.

For more information about the future for pain management, see the National Strategic Action Plan for Pain Management: https://www.painaustralia.org.au/static/uploads/files/national-action-plan-11-06-2019-wfflaefbxbdy.pdf