Treatment of Pain and Inflammation

A disorder or injury that produces pain and inflammation can interfere with rehabilitation therapy. So physical therapists and other members of the rehabilitation team treat pain and inflammation before and during therapy. Techniques used include heat therapy, cold therapy, electrical stimulation, traction, massage, and acupuncture.

Heat therapy helps make joints less stiff and easier to move. It reduces pain and muscle spasms. Heat therapy is used for such problems as sprains, strains, muscle spasms, and various forms of arthritis. Heat may be applied to the surface of the body with hot packs, an infrared heat lamp, whirlpools (hydrotherapy), or heated wax. A limb may be immersed in heated wax (paraffin baths), or heated wax may be applied to part of the body. For diathermy, heat may be applied to deeper tissues through sensors (electrodes). For ultrasonography, a high-frequency sound (ultrasound) device placed on the skin is used to apply heat. Heat is applied carefully to avoid burns.

Cold therapy (cryotherapy) may help relieve pain and muscle spasms. It may reduce swelling after an injury occurs. Cold may be applied to the surface of the body with an ice bag, a cold pack, or fluids that evaporate quickly (and thus cool). Therapists apply cold carefully to avoid damaging tissues and lowering the body temperature too much (resulting in a disorder called hypothermia), particularly in older people.

Traction is occasionally used to reduce pain and muscle spasms as well as to keep bones aligned while fractures heal. Traction involves applying a gentle, steady pulling action. Traction may be applied to different parts of the body. For traction of the neck (cervical traction), a sling is fitted under the chin and wrapped around behind the head. This type of traction may relieve chronic neck pain.

Massage may relieve pain and reduce swelling. It may help make tight muscles, ligaments, and tendons easier to move. Massage may help people who have low back pain, arthritis, bursitis, neuritis, fibrositis, multiple sclerosis, cerebral palsy, or various degrees of paralysis.

Acupuncture may be used in rehabilitation to relieve pain. The application of a low electrical current through hair-thin needles inserted at specific body sites may stimulate nerve activity. Chiropractic may be used to relieve low back pain.

Most people feel some pain during the first few days of rehabilitation. Pain relievers (analgesics) can be taken. If pain seems excessive, people should tell a health care practitioner.