Despite having chronic pain for six months now, I'm still working and keeping up. The doctor thinks it might help me to see a physical therapist. But how can they help? I can run 10 miles, pump iron, and keep up with the best of them.

It's clear that some people cope with pain using endurance strategies. They increase rather than decrease their exercise and activity. If this describes you, you may not benefit from a rehab program that focuses on increasing your physical fitness. That type of program would just overload your muscles even more.

You may need a specialized program. The therapist will assess you for specific disabling activities or changes in activity pattern that you may not even be aware of. The therapist may be able to help you learn better ways to move that won't load your spine as much.

And it's possible there are ways to modulate your pain so that you can continue doing what you want to do activity-wise with less pain and/or discomfort. Chronic pain has a way of changing how your body moves and perceives movement. Based on this fact, you may be at increased risk for future injury.

The therapist can help you regain normal proprioception (sense of joint position) and kinesthesia (awareness of movement). If there is a movement impairment of any kind, the therapist can guide you through specific exercises and patterns of movement to restore full and normal motion.

Reference: 

Eric J. Bousema, et al. Disuse and Physical Deconditioning in the First Year After the Onset of Back Pain. In Pain. August 2007. Vol. 130. No. 3. Pp. 279-286.

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