Your questions, answered

What patients ask us most about pain management, in plain words.

Why does my pain last when the injury should have healed?

Pain is the body's alarm system. After weeks or months, the alarm can become more sensitive, so it goes off more easily. The pain is real, but it does not always mean more damage. Understanding this is part of the treatment.

Do I need an MRI first?

Usually not. For most back and neck pain, a careful assessment tells us more than a scan, and many scan findings are also common in people with no pain at all. We refer you for imaging when the assessment shows it is needed.

Should I rest until it stops hurting?

For most muscle, joint and back pain, staying active helps more than resting. We find the amount of movement your body accepts today, and build from there.

Are painkillers enough?

Medication can help in the short term, and that is your doctor's decision. On their own, painkillers rarely fix the cause. For long-lasting back pain, guidelines recommend starting with treatments such as exercise, hands-on care and rehabilitation.

What does a pain management plan include?

A clear explanation of your pain, hands-on treatment to calm it, exercise that rebuilds strength and confidence, and a step-by-step return to the things you have been avoiding.

How long until it gets better?

Many people notice a change within a few weeks. Pain that has lasted for years takes longer. The goal is steady progress you can see: moving more, sleeping better, and doing more of what you enjoy.

What the research shows

Key findings from systematic reviews, randomised trials and major studies indexed on PubMed. Numbers link to the full references below.

Guidelines put active care first

Clinical guideline · ACP

For long-lasting low back pain, the guideline strongly recommends starting with non-drug treatment, such as exercise, multidisciplinary rehabilitation, motor-control exercise and spinal manipulation, before medication.[1]

Large, lasting improvement

Randomised trial · 492 patients

In people with chronic, disabling low back pain, cognitive functional therapy delivered by physiotherapists, which works on how people understand, move with and live with their pain, improved activity far more than usual care. The effect was still there at one year, at a lower overall cost.[2]

Better together: body and mind

Cochrane review · 41 trials

In 6,858 people with long-lasting low back pain, rehabilitation that combines physical treatment with psychological or work-focused support reduced pain and disability more than usual care, and improved the chance of being at work one year later compared with physical treatment alone.[3]

Better together: education and exercise

Meta-analysis · 5 high-quality trials

Adding pain neuroscience education (learning how pain works) to exercise reduced pain by about 2 points out of 10 more than exercise alone in the short term, and also reduced disability and fear of movement.[4]

Better together: back pain

Meta-analysis · 8 trials

In chronic low back pain, adding pain education to physiotherapy treatment improved pain and disability in the short term, with moderate-quality evidence.[5]

How we use it at Dr. Phyx

We start by listening and explaining what is likely driving your pain, and what it does and does not mean. Then we calm things down with hands-on care and, when useful, techniques such as dry needling, and rebuild movement and strength step by step.

We set goals that matter to you, such as sleeping through the night or getting back to the gym, and track them together.

Always by a qualified specialist, after a full assessment, because your health comes first.

When we are careful

Some pain needs a doctor first. Get medical help promptly if you have:

Back pain with numbness around the groin or buttocks, or new problems controlling your bladder or bowels: seek urgent care
Pain with fever, unexplained weight loss, or a history of cancer
Severe pain at night that does not change with position
Pain after a significant fall or accident
Chest pain, or pain spreading to the jaw or left arm: call emergency services

Living with pain that won't settle?

Send us a message on WhatsApp. We will tell you honestly whether it suits your case, and book a first assessment if it does.

Ask on WhatsApp

References

Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. PubMed · doi:10.7326/M16-2367
Kent P, Haines T, O'Sullivan P, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial. Lancet. 2023;401(10391):1866-1877. PubMed · doi:10.1016/S0140-6736(23)00441-5
Kamper SJ, Apeldoorn AT, Chiarotto A, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015;350:h444. PubMed · doi:10.1136/bmj.h444
Siddall B, Ram A, Jones MD, Booth J, Perriman D, Summers SJ. Short-term impact of combining pain neuroscience education with exercise for chronic musculoskeletal pain: a systematic review and meta-analysis. Pain. 2022;163(1):e20-e30. PubMed · doi:10.1097/j.pain.0000000000002308
Wood L, Hendrick PA. A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: short- and long-term outcomes of pain and disability. Eur J Pain. 2019;23(2):234-249. PubMed · doi:10.1002/ejp.1314

This article is general information reviewed by a physiotherapist. It is not a diagnosis or a personal treatment plan.