Many people tend to think about pain simply as damage to a joint, muscle, or bone that seems isolated from the rest of the body. The only way to treat it, then, is to target the damaged area with exercises and other interventions that are intended to heal it and alleviate the pain. But research has been showing that pain is far more complex than this, and that there are many other factors at play. In particular, it’s been found that our psychological state and perception of pain or injury often have a significant impact on how pain is experienced. This understanding has led to the development of psychologically-informed physical therapy (PIPT), which puts a slightly different spin on the traditional model of care. Below, our New York City physical therapists explain how PIPT works and why it may lead to even better outcomes for you.
The bedrock of physical therapy has always been the use of movement-based strategies that are individualized to each patient and designed to reduce their pain levels and improve functional abilities. PIPT completely retains these core values, but it takes a much broader approach than the traditional methods used to manage pain. In addition to concentrating on the physical issue responsible for a patient’s pain, a major focus of PIPT is to also address the behavioral aspects of pain—which is essentially how each person responds to their pain. This is primarily accomplished by identifying each patient’s individual expectations, beliefs, and feelings, and using them as factors that will help predict their chances of having a successful outcome.
The overall goal of PIPT is to prevent disability in each patient by helping them to better understand the complex nature of their pain, making treatment plans extremely personalized, and stressing adherence to treatment plans in order to improve outcomes and reduce associated costs. It involves a range of specific techniques, some of which are slight variations on traditional physical therapy methods, while others are completely unique to PIPT. Below are five of the fundamental principles of PIPT:
5 fundamental principles of PIPT from our New York City physical therapists
- Biopsychosocial approach: this means that the physical therapist will be looking at your pain as the result of biological, psychological, and social factors, and they will educate you regarding this concept so you can better understand how things like your mood, perception, and history with pain all contribute to your overall experience
- Behavioral aspects of pain: this relates to the above principle and focuses exclusively on how your behaviors directly influence your perception of pain; by better understanding this connection and working to change your behaviors, you’ll be able to take more control over pain’s impact on your daily life
- Strong emphasis on interviewing: the initial interview has always been one of the most important steps of physical therapy, and there’s an even stronger emphasis on it in PIPT; the main difference with traditional physical therapy is that you’ll be asked detailed questions about your mental state and daily interactions—for example—in addition to your physical condition
- Therapist reinforcement: this is another standard component of all physical therapy programs that receives even more attention in PIPT; your physical therapist will provide you with ongoing support as you follow your treatment plan and as you display signs of improvement, which has been found to yield better outcomes for patients
- Individual techniques or protocols: in addition to the pain-relieving treatments (like ice, heat, and ultrasound) and movement-based interventions (like various exercises and manual [hands-on] therapy) typically used in physical therapy, other individual techniques like relaxation training, guided imagery, problem solving, and cognitive and behavioral training strategies
- Another commonly used intervention is biofeedback, which teaches patients how to control certain functions of their involuntary nervous system (like heart rate, temperature, muscle tension, and blood pressure); this is done through a device that measures one of these bodily functions as the patient modifies their response accordingly
PIPT has technically been around for about 30-40 years, but a strong interest in it has been developing over the past decade or so. A growing number of physical therapists are now using PIPT as a part of their approach to care in order to screen and better target treatments for many patients, especially those who are at a high risk for pain-related disability. Research has also shown that it’s effective for a number of common painful conditions, as several studies have found PIPT to be more effective than traditional physical therapy for neck pain, low back pain, knee osteoarthritis, chronic knee pain, and degenerative disc disease. If you’re interested in learning more about PIPT or are currently dealing with pain of any sort, our New York City physical therapists are happy to assist you. Contact Dynamic Sports Physical Therapy in New York City at 212-317-8303 to schedule an appointment today.