Health and Wellbeing

Chronic pain: medication or physiotherapy?

Dec 2 2021

Millions of individuals in the UK struggle with physical pain every day. Many rely on medication, while others choose methods such as physiotherapy, massage, acupuncture and more. But what’s the best remedy for pain and what are the pros and cons of using medication? Dr. Harshi Dhingra, Associate Professor in Pathology at the Adesh Institute of Medical Sciences andResearch, explains… 

What is Chronic Pain? 

Chronic pain is defined as pain that lasts longer than three to six months. It’s an ongoing pain that can often be linked to a variety of conditions including disease, arthritis, and long-term injuries. This is separate to acute pain, which comes on suddenly and is caused by something specific. A sports injury for example. It’s estimated that one third of people in the U.K. (28 million adults) experience chronic pain. A high number of those people rely on anti-inflammatories, muscle relaxers and prescription painkillers, including opioids. But how do they work and what are the side effects?

How do painkillers work? 

Prescription opioids are pain-relieving drugs that work by interacting with opioid receptors in your cells. When opioid medications travel through your blood and attach to opioid receptors in your brain cells. The cells release signals that muffle your perception of pain and boost your feelings of pleasure. If you’ve experienced an uncomfortable pain for a sustained period of time, this sounds like a great go-to option for pain relief, right? Absolutely! When used as directed by your doctor, opioid medications can safely help control pain. But there can be side effects if used long term…

Do painkillers have side effects? 

The Faculty of Pain Medicine at the Royal College of Anaesthetists reports that long-term use of prescription painkillers such as opioids can have negative side effects. These include drug addiction, abnormal pain sensitivity (opioid induced hyperalgesia), interruptions to the immune system and the endocrine system (a series of glands that produce and secrete hormones that the body uses for a wide range of functions.) That’s a lot of potential side effects for a form of pain relief that doesn’t directly treat the cause of pain.

While painkillers are extremely beneficial in immediate circumstances, such as post operation or injury, they do not treat the cause. Painkillers are plasters, not cures.

How can physiotherapy manage pain relief? 

physiotherapist is a healthcare professional who provides non-invasive care to relieve a variety of conditions including pain. A physiotherapy treatment programme can include manual therapy and massage. It can also require the patient to perform a series of prescribed exercises that help treat the root cause of the pain.

There are several advantages to using physiotherapy to treat pain, as an alternative to long-term pain killers. Unlike painkillers, physiotherapy is non-invasive and it doesn’t cause side effects on your organs or internal systems. Most notably, it treats the cause of pain.

“Physiotherapy is so much more than pain relief. We work holistically with our patients to identify the root cause of their discomfort so that we can provide them with a clear, easy-to-follow treatment plan that’s designed to eliminate the cause of pain, and get them back to enjoying life at its best again”, says Bodyset physiotherapist, Charlie Kydd.

Physiotherapy treatments that are designed to relieve pain can include the following:


A physiotherapist will often use massage to treat injuries related to muscles, and tendons.

Exercise therapy

A physiotherapist can teach a patient how to perform exercises in clinic and at home.

Hot and cold treatment

Cold treatment can reduce inflammation, which can ease painful joints and muscles. Heat treatments can promote blood flow which is relaxing for muscles. Heat therapy is particularly effective at reducing pain caused by arthritis or chronic muscle pain.

Dry Needling

Dry needling is performed by physiotherapists to treat a variety of musculoskeletal conditions to reduce pain and restore function.


Therapeutic ultrasound uses two primary treatment methods. The first is deep heating for ligaments, tendons, and muscles to improve circulation and reduce pain. The second is called cavitation, which speeds up cellular processes and improves healing.

There are several specific improvements a person may see after following a bespoke physiotherapy treatment plan.

Improve mobility

Improving mobility can help a person enjoy a higher quality of life and may prevent some individuals from taking medication for associated side effects such as depression.

Avoid surgery

Surgery can’t always be avoided but physiotherapists do all that they can to encourage a patient’s body to heal itself without the need for surgery.

Pain reduction

Physiotherapy provides an excellent alternative to starting painkillers or remaining on them for long periods of time.

Injury recovery

The faster a person heals from any type of injury, the less need there is to take or stay on painkillers. Physiotherapists work with you to heal the root cause of pain.

Management of age-related issues

As people age, pain in the muscles and joints often increases. Physical therapy can reduce or even eliminate age-related problems and limit the need for medication.

Reduced or zero medication

The Chartered Society of Physiotherapy states that physiotherapy can play an important role in preventing opioid addiction and helping in the recovery process.

In summary, doctors can prescribe a variety of medications to treat chronic pain. But with side effects in mind, it’s always worth trying a different approach first…

Dr. Harshi Dhingra is a licensed medical doctor with specialisation in Pathology. She is currently employed as faculty in a medical school with tertiary care hospital and research centre in India as well as a medical review for Sunshine Behavioural Health. She has vast experience of over a decade in diagnostic, clinical, research and teaching work. She has strong interest in medical content writing and reviewing. She also has several publications and citations in indexed peer reviewed journals.

Are you in pain?

If you’ve been experiencing chronic pain, acute pain, or a niggling discomfort that won’t go away, please get in touch to book an appointment. Our physiotherapists are here to listen, provide actionable steps and advise on what to do next.