Summary: | Examples of physical therapies used in the management of chronic pain include exercise and active physical therapy, yoga, manual therapies (such as spinal manipulation therapy and mobilization), acupuncture and massage. Physical and exercise therapies are varied and may include exercises to improve range of motion and muscle conditioning to increase the degree of stability and function and improve pain control. Exercises can be passive, during which external force is applied and there is no voluntary muscle contraction or can be active, assisted with partial contraction and external force applied. Acupuncture is an intervention that involves the insertion of needles at specific acupuncture points. In the management of chronic pain it has been hypothesized that acupuncture induces changes in the perception and memory of pain and may induce changes in the sympathetic nervous system. Massage therapy has been defined as "as soft tissue and joint manipulation using the hands or a handheld device" for therapeutic purposes and is another example of a physical therapy used to help control pain. Massage therapy is thought to have a broad range of benefits related to relaxation and circulation. Familiarity with the evidence-based guidelines around the use of physical therapies to manage chronic pain is important given the diverse therapeutic modalities available in this category, the diverse nature of chronic pain syndromes and the potential for varied efficacy. This report will review existing evidence-based guidelines regarding the use of physical therapy treatments for chronic non-cancer pain
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