Persistent pain
Chronic Pain Physiotherapy in Singapore
Pain that has outlasted the healing is a different problem from pain that is still healing.
Tissue heals on a timetable. Most soft tissue is structurally sound by twelve weeks. When pain is still there at six months, something other than tissue damage is keeping it going, and it needs to be assessed on its own terms rather than treated as an injury that is taking a long time.
No referral needed to start. Bring any scans or reports you have.
First, a check
Is this actually chronic pain?
Quite often it is not, and that matters because the two are treated differently.
Still a joint or tendon problem
If the pain is in one place, has a clear pattern, and specific movements reliably provoke it, that is usually a mechanical problem that has been going on a long time rather than chronic pain in the clinical sense. It is assessed and treated as the joint or tendon problem it is.
Persistent pain
Pain beyond expected healing time, often spread across more than one area, variable day to day, frequently worse with stress or poor sleep, and not tracking with what imaging shows. This is what the rest of this page is about.
What we assess
Why pain persists after the tissue has healed
Several things can keep pain going once the original problem has settled. An assessment works out which of these apply to you, because they need different treatment.
Load tolerance has dropped
Months of doing less leaves tissue able to handle less. The pain then arrives at lower and lower thresholds, which feels like the problem getting worse rather than the capacity shrinking.
The nervous system has become sensitised
A protective system that has stayed switched on reports pain at loads that would not normally hurt. This is a real, measurable phenomenon, not a way of saying the pain is imagined.
Movement has reorganised around it
Avoiding one movement for months loads something else instead. The second area starts to complain, and the picture becomes harder to read.
Sleep and stress are feeding it
Both measurably change pain threshold. Neither is a psychological explanation for the pain; both are levers that change how much of it you feel.
There is a nerve component
Burning, electrical or glove-and-stocking symptoms behave differently from mechanical pain and respond to different treatment.
Something was missed
Occasionally the original assessment did not capture the whole picture. A fresh examination is worth doing before assuming the pain is purely persistent.
Conditions
Long-term conditions we see
If the pain follows an operation, the post-surgical pathway is usually the better starting point, because the protocol and the timeline are different.
Physiotherapy after surgery → · Browse all conditions we treat →
What happens
How the assessment works
1. The history, properly
When it started, what has changed since, what has already been tried, and what you have stopped doing because of it. The last one usually tells us the most.
2. Measurement
Range, strength, and the specific loads that provoke it, written down. Persistent pain varies day to day, so progress is judged against numbers rather than against how a given appointment felt.
3. A graded plan
Load reintroduced in steps small enough not to flare it, reviewed against the measurements. You get the number of appointments the plan needs and the review points, in writing.
Appointments are 45 minutes at $230. Persistent pain is usually a longer course than an acute injury, and progress is rarely linear. Your therapist gives you a realistic range at the first appointment and reviews it at set points rather than open-endedly.
Questions we get asked
My scan was clear. Does that mean nothing is wrong?
No. Imaging shows structure, and structure is only part of what produces pain. A clear scan is useful information, because it rules things out, but it does not settle whether there is a problem or what to do about it. That comes from examination.
How long will this take?
Longer than an acute injury, and we will not put a date on it. What we will do is set review points and measure against them, so you can see whether the plan is working rather than waiting to find out.
Will exercise make it worse?
Unplanned loading can flare it. Graded loading, introduced in steps and reviewed, is the part of treatment with the strongest evidence behind it. The skill is in the grading, which is what the assessment is for.
Is this in my head?
No. Sensitisation is a measurable change in how the nervous system processes signals. Sleep and stress change pain thresholds physiologically. Saying those things influence pain is not the same as saying the pain is not real.
I have already tried physiotherapy.
Tell us what was done and how you responded, including what did not help. That is useful information and it changes where we start. Bring any notes or reports you have.
Should I see a doctor as well?
Often yes, and we will say so. Persistent pain frequently needs more than one discipline, and some presentations need medical investigation before physiotherapy is the right next step. We will tell you if that applies.
Where we are
Five clinics across Singapore
Tell us how long it has been
Where it hurts, when it started, what you have already tried, and what you have stopped doing because of it. We will tell you whether an assessment is the right next step, and what it would involve.
What our patients say
Google reviews from our clinics in Singapore.
