The role of specialist physiotherapy in a pain management clinic – traditional and novel approaches

There is no doubt that coronavirus disease (COVID-19) has had a drastically negative impact on the NHS, as well as many other public services, individuals and families. The role of physiotherapy in managing chronic pain is challenging; even more so with the added burden of COVID-19. As COVID-19 cases increased many non-urgent outpatient services were suspended: This district general hospital continued to offer some appointments, albeit limited, but were they beneficial? This article not only considers the multidisciplinary approach to manage chronic pain; focusing on the bio-psycho-social model, which incorporates a variety of specialities within a pain clinic but also the impact of COVID-19. It considers both the clinicians' and patients' experiences respectively of offering, and receiving, key physiotherapy treatments such as patient education, patient empowerment, exercise and function; how these were modified, sometimes with digital support. It gives some insight into the differing patient responses and attitudes such as patients who fear exercise; those who expected physiotherapy to be a ‘hands-on treatment’ and the challenges of ‘remote’ patient supervision. Alternatives to educational groups are described and the patients' responses to them. Other treatments such as phased activities, goal setting, cognitive functional therapy, desensitization, mirror therapy, virtual reality, yoga, tai chi, and acceptance and commitment therapy are briefly outlined.