Chronic pain - understanding, accompanying, changing

May 25

What physiotherapy and occupational therapy can do today

Chronic pain affects millions of people - and yet it often remains misunderstood. When pain persists for weeks and months, even though no acute cause can be identified, an invisible battle begins: against exhaustion, insecurity, withdrawal, powerlessness. But chronic pain is not an inevitable fate. On the contrary, there are now effective, interdisciplinary therapy concepts in which physiotherapy and occupational therapy in particular play a central role.

When do we speak of chronic pain?

Chronic pain is when pain lasts longer than three months or persists beyond the normal healing process - and thus becomes a disease in its own right. It often occurs in conjunction with:

Back pain
Joint diseases (e.g. arthrosis)
Fibromyalgia or rheumatism
Neuropathic pain
Migraine or tension headache
Long COVID, endometriosis or tumor diseases

Important: Chronic pain is not imaginary - it is the result of complex neurophysiological changes. There is often a so-called central sensitization: The nervous system reacts hypersensitively, pain stimuli are perceived more strongly, even harmless stimuli can be perceived as painful(allodynia).

Pain is not the same as damage - the new understanding of pain

Modern pain research shows that chronic pain is not just a signal of tissue damage, but the result of a complex interplay between the body, nervous system, psyche and environment. It is caused by:

Overactive nerve cells in the spinal cord and brain
impaired pain inhibition
Stress, anxiety, emotional strain
Lack of exercise, protective behavior, isolation

That's why chronic pain doesn't need painkillers - it needs a comprehensive treatment concept.

Physiotherapy for chronic pain - movement as a message to the nervous system

Physiotherapy today is much more than just manual treatment. It is a key to active pain regulation - through targeted movement, vegetative calming and building body confidence.

Therapeutic focus:

Gradual increase in load - adapted to the individual condition
Exercise training despite pain - without excessive demands
Breathing, relaxation and regulation techniques
Training body awareness and quality of movement
Medical yoga and sensorimotor strategies for self-regulation

Principle: Movement is not a risk - but the way back to the ability to act.

Occupational therapy - getting back to everyday life

Chronic pain doesn't just affect the body - it affects everyday life as a whole. Many people lose their professional role, their social connection and their life structure. This is where occupational therapy comes in.

Occupational therapy approaches:

Pacing and energy management - how much activity is possible?
Adaptation of everyday life and environment (e.g. ergonomic, stress-reducing)
Training everyday skills despite fatigue, pain or sensory overload
Goal work and resource activation - what is good for you, what gives you strength?
Creative or physical methods to promote expression and self-awareness

Goal: Better quality of life through everyday success - not through "curing", but through adaptation and development.

Biopsychosocial model - seeing the whole person

At Hockenholz, we understand chronic pain as a multifactorial phenomenon. Our work is based on the biopsychosocial model: we not only look at the pain, but also at the history, environment, stresses and strengths of each individual.

Our approach includes:

Pain education: How does pain arise? How can it be influenced?
Bodywork & movement: sensitive, individual, effective
Vegetative regulation: breathing, relaxation, rhythm
Strengthening self-efficacy and autonomy
Interdisciplinary collaboration with doctors, psychologistsand therapists

Conclusion: Chronic pain is treatable - if we think differently

Chronic pain is real, complex - and has a profound impact on life. But it is not synonymous with stagnation or helplessness. With a professional, empathetic and evidence-based therapeutic approach, it is possible to regulate pain, regain quality of life - and get moving again. The key: understanding, support, change.

Are you a therapist and want to learn how to effectively support people with chronic pain?
Then find out more about our practical training courses on pain physiology, psychosomatic support and movement-based therapy:
👉 www.hockenholz.com/weiterbildungen

Are you affected yourself?
We support you - individually, professionally and at eye level. In our practice in Berlin or via online counseling.

Back pain, lumbalgia, non-specific back pain, back trainingChronic pain, understanding pain, multimodal pain therapy, biopsychosocial pain model, central sensitization, conservative pain therapy, vegetative regulation, self-efficacy, pain education, body awareness, pain and everyday lifePhysiotherapy, occupational therapy, medical yoga, movement therapy, sensorimotor training, visceral techniques, respiratory therapy, manual therapy, pain coaching, educational therapy, adaptation to everyday lifeWhat to do with pain, Pain without findings, Learning to understand pain, Help with chronic pain, Back pain without surgery, Movement despite pain, Training for pain, Pain and psyche, Physically active despite diagnosis, Treating functional complaints.

Florian Hockenholz https://www.hockenholz.com