Our Passion is Change
Suite 2B-2 Flinders Pde, North Lakes
Mon-Thu 08:30 - 17:00 / Fri 08:30 - 14:30
31 Aug 2018
Chronic pain pic Marianna


By Marianna Bernal, Physiotherapist


Pain is said to be chronic if it persists for more than three months. Many people are new to the notion of chronic pain because they are taught that pain goes away when tissues heal after an injury or illness. However, this is not the case for 1 in 5 Australians, as pain may not lessen after the healing process.

Chronic pain is complex because it involves the central and peripheral nervous systems, made up of the brain and spinal cord and may not be easy to treat, especially with analgesia alone. Persistent pain affects the individual as well as their family, friends and wider community.

Pain can become chronic due to changes to the nerves or nervous system which keeps firing and signaling pain. These changes can be unrelated to the original diagnosis or injury. Pain levels can be intense and unrelenting as well as lead to various degrees of disability if not managed well.

Pain is the body's way to let you know when you are sick or injured as it leads people to take action. Pain has been crucial in humans' ability to evolve and survive. This type of pain is acute pain (nociceptive pain) and is a reaction to noxious or painful stimulus. Acute pain is generally simple to treat and tends to fade away as the healing process takes place.

Chronic pain may not be warning you of damage occurring in the body as there is no longer a direct link between pain and harm being caused by the (preceding) injury.


It is widely accepted in the medical/ health professions that management should be holistic, involving all aspects of the client’s life. A Biopsychosocial model of assessment and management is now used and basically means that three aspects should be considered to provide good health care:

  1. a) Bio – biological: the physical body should be assessed for changes or injury,
  2. b) Psycho – psychological: the aspects of anxiety and stress should be addressed,
  3. c) Social – aspects of the social situation and home/ work environment should be considered.

These three aspects will have a bearing upon your pain experience although is not possible to determine how much of each is contributing to the chronicity of pain.


The most important person in managing your pain is you. It has been shown in clinical studies that the more you understand about the mechanisms of pain; the better you can control it. You know more about your pain than any health professional, you live with it every day; although you will need some guidance from trained health professionals.

A holistic approach usually involves a team of health professionals (doctor, physiotherapist, psychologist, social worker, etc). They will assess you and advise you on the best course of action, including education and graded physical activity.

The most common areas of pain management are:

  • Medication
  • Physical activity
  • Psychology


Movement gives the nervous system and the brain a lot of feedback about the body and the environment around us; it helps to normalise the nervous system.

Physical activity has many positive effects on our bodies: helps to keep heart and lungs healthy, improve muscle and joint function and stimulates you mentally.Chemicals released during exercise will also help to reduce your sensitivity to pain.

In the early stages, people often want change to happen quickly, however; this can result in pain flare-ups. A more gradual systematic approach is required with small increments of activity. It may be that the limitation to exercise is your major concern.

Therefore, seeing a Physiotherapist to improve your tolerance to exercise as well as decrease pain severity may be a way to start. Our fully qualified Physiotherapists can assist you on grading and pacing your physical activity to recondition your muscles and joints and assist you with persistent pain through many exercise modalities:

  • Clinical Pilates
  • Exercise Based Rehabilitation
  • Hands on Physiotherapy
  • Hydrotherapy

It therefore takes time, practise and patience for people to learn and effectively implement new strategies. Learning to deal effectively with flare-ups of pain is an important part of the management.

Some of the most common chronic pain conditions are listed below:

  • Back pain
  • Ankle and foot pain
  • Chemotherapy-induced pain
  • Cluster headaches
  • Complex regional syndrome
  • Fibromyalgia
  • Frozen shoulder
  • Headaches
  • Joint pain
  • Neuropathic pain
  • Osteoporosis
  • Radicular pain
  • Sciatica
  • Shingles
  • Trigeminal neuralgia
  • Tennis elbow




02 Aug 2018

Extra care of dry skin needed in winter

By Pam O’Connor

Have you noticed your skin has been feeling dry or flaky? If so, that’s because our skin is usually drier at this time of year.

I’ve certainly been using a lot more massage oil or lotion lately on my clients!

It’s important to take extra care of our skin in winter, especially if you have lymphoedema, diabetes or skin conditions such as eczema.

Why is our skin drier in winter?

In winter the humidity is lower – the air outside is colder and drier, making the water in your skin evaporate more quickly. Windy conditions make this worse.

Using heaters indoors also dries out your skin, especially the heaters that blow hot air. Our mucous membranes also dry out, resulting in dry throats and chapped lips.

We tend to take longer hot showers and baths in winter, but this can strip your skin of its protective oils and allow moisture to escape.

When it’s cold our blood vessels constrict or become narrow, thus less blood supply and nutrients delivered to the skin means it becomes less healthy.

Taking care of our skin

The skin is our body’s first line of defence against infection so looking after our skin is important for a healthy immune system.

Most soaps and cleansers are highly alkaline and too harsh. Our skin is slightly acidic with a pH level of around 5.5, so it’s best to use soap-free washes to protect the skin’s acid mantle.

After your bath or shower, don’t rub but pat the skin dry gently with a soft towel and immediately apply the right moisturising body lotion while the skin is still slightly damp to help lock in the moisture before it dries out.

Dry carefully in-between toes but to avoid the risk of fungal infections, don’t apply any moisturiser.

Avoid using abrasives such as scrubs or loofahs that may damage the skin. Simply use your hands to lather up.

Drink plenty of water. Our bodies are made up of about 60% of water so healthy skin needs to stay well hydrated even though we may be less active and less thirsty in the cooler months.

As we get older our skin becomes thinner and loses its elasticity so it’s even more important to protect it from damage.

Our harsh Australian climate means we have a high incidence of skin cancer so make sure you check your skin regularly and make an appointment at the skin doctors at least once a year.

The right products

With so many skin care products around it can be rather confusing to find what’s right for your skin.

Look for a natural skin care range with no colours, perfumes, parabens, petrochemicals, paraffin, propylene gycol, sulphate surfactants (SLS) and detergents – to avoid irritation to sensitive skin. This is particularly important for people with problem skin such as eczema.

You will usually find soap-free washes in a different section or aisle in supermarkets and chemists to normal soaps and cleansers. Some of these soap-free alternatives include Nutri-Synergy, QV, DermaVeen, Sukin, Alpha Keri, Dermal Therapy, Dermeze, and Hope’s Relief.


As someone who has lymphoedema I know it is absolutely essential to look after your skin if you have this condition as you are highly susceptible to cellulitis, a serious bacterial infection of the skin.

Swollen limbs can result in skin changes including dry, cracked skin creating an entry point for infection. Cracked heels and in-between toes are a popular breeding ground for bacteria to flourish in an already-impaired lymphatic system, so the feet need particular attention.

Many people with lymphoedema wear compression garments so natural moisturisers with fast absorption are best for skin comfort as well as protecting the garment’s elasticity.


People with diabetes often experience less sensation in their feet due to nerve damage or reduced blood circulation, so daily care is needed to avoid infection or non-healing wounds that may lead to amputation.

The risk is higher for people who have had diabetes for a long time, high blood glucose levels for an extended period, smokers and those who are generally inactive (Diabetes Australia). Moisturising the feet is important to avoid dry skin causing damage. Getting your feet checked by a podiatrist regularly is recommended.

Nutri-Synergy samples

Next time you come in for your appointment at Lime Physical Therapy, make sure you pick up a free sample pack of Nutri-Synergy products for dry skin. The pack includes samples of cleanser, moisturisers and Skin Repair for damaged skin.

free hand cream