Manuel Casado: pain treatment service and digitalization

Pain and physiotherapy units

Remember that nociception is nothing more than a physiological alarm signal in the face of a dangerous situation for the body. A complex process by which the peripheral nervous system (PNS) transmits information about noxious stimuli to the spinal cord and brain, where it will be interpreted and experienced as pain.

When it lasts for more than 3 months, it is defined by consensus as chronic (although this is a simplification that cannot cover all existing pathologies).

In addition, it is considered a major health problem that affects 25-35% of the world’s adult population (Aitken D et al, 2015) and whose cost is estimated to be incalculable. If it is of a chronic type in the lower back, it is known that it represents an investment of 350-560 million dollars a year in the US (Puentedura et al, 2016).

Physical activity has analgesic effects and reduces the presence of pro-inflammatory cytokines, reversing hyperalgia: moderate aerobic exercise that lasts for around 30 minutes reverses hypersensitivity due to the increase in endogenous opioids and suppresses excess substance P, activating pathways inhibitory of nociception at the central level and modulating its perception (Urtubia et al. 2015).

It is not surprising then that when faced with a patient with non-specific low back pain, for example, exercise protocols are used to increase their pain threshold. All this without disdaining the various techniques of physiotherapy that we can use in this and other cases, from massage therapy to percutaneous electrostimulation. Some simply for analgesic purposes and others to achieve the correct functional rehabilitation of the patient.

That is why it is essential to include therapeutic exercise in the pain units of hospital centers or in specialized clinics such as Pain Medicine that help patients to alleviate and treat their condition.

Let us remember, once again, that the exercise must be adapted to each patient, especially if they are facing a chronification, since they tend to be people who suffer from biomechanical and functional deficiencies, muscular weakness and flexibility as a result of a long period of inactivity.

TRAK provides a tool for rehabilitation professionals to facilitate the prescription of therapeutic exercise programs that guarantee the prevention and monitoring of the condition of their patients. We make physiotherapy more accessible by allowing the patient to rehabilitate at home using their mobile camera.