One in every five adults in Malta suffers from chronic pain, which is defined as long-term pain that lasts over three months. World Physiotherapy Day, marked today, is dedicated to draw attention to the role physiotherapy plays in helping people manage, or even overcome, this sort of pain. Claudia Calleja reports. 

Two years ago, Marina Hollingworth, who had been suffering from chronic back pain for 14 years, went for her first physiotherapy session in a wheelchair.

Standing up was unbearable and doing the exercises recommended by her physiotherapist were too hard to carry out.

But Marina pushed through and trusted in her physiotherapist, Emanuel Schembri, who encouraged her to stick with the programme. Now Marina, aged 71, only uses her wheelchair for long distances.

“I can walk to the grocer. I can walk around my house. This is my miracle,” she says.

Marina's story

Marina started suffering from sharp back pain in 2003. At the time she lived in the UK, working in a care home where she spent years lifting patients. As the pain grew worse, she could barely move and had to quit her job.

“It was simply a matter of wear and tear. You don’t think about what’s happening to your body as you live your life… There was a time when even lying in bed was painful. It was better for me to sleep sitting in a chair. I underwent lots of tests and X-rays… I couldn’t move. I was in extreme pain…. I walked till I couldn’t walk anymore. I used to drag my right leg behind me. But, with time, it just got unbearable and I just had to use a wheelchair,” she says.

Physiotherapist Emanuel Schembri urges all patients to follow their exercise programme to see results. Photo: Mark Zammit Cordina

Then, three years ago, Marina and her husband moved to Malta. She was referred to the Outpatients Physiotherapy Department at St Luke’s Hospital. That’s where she met Emanuel.

My miracle is that I can walk around my house

“I cannot thank him enough. In the beginning, I admit, I found the exercises he gave me very hard. I thought they were barbaric at the time,” she laughs.

“I remember thinking: I cannot do this. But he encouraged me. I had to work for it. I did. And slowly I started seeing results. I started trusting him. This was the first time I had made a connection with a physiotherapist – who followed me all the way.

“Physiotherapy can help you move better. I won’t be walking up Mellieħa hill, but I can walk around my house. It’s painful, but it’s worth doing. It’s given me a new life. A life that I had lost,” she says.

Physiotherapy and chronic pain

Chronic pain has a multidimensional impact on the lives of patients which is why treatment needs to cater for their physical, psychological and social wellbeing, explains physiotherapist Emanuel Schembri.

“This type of persistent and consistent pain can lead to de-conditioning – because people experiencing this pain don’t move around much, their bodies become weak. This is where physiotherapy can support immensely. And this has a psychological and social impact on the patient’s quality of life.

“We try to get rid of the pain completely, but this is not always possible. We do, however, help people remain active and, as a result, they can move around and continue living their lives,” he says, adding that the patient’s commitment to following the exercise programme was extremely important.

Victoria Massalha, Professional Lead of Physiotherapy Services within the Ministry of Health, explains that exercise therapy is included in all guidelines for the treatment of chronic pain.

“Physiotherapists have unique skills to recommend specific individualised exercise programmes according to the condition. Exercise aids in maintaining flexibility and movement and helps to strengthen bones and muscles. It is also important for cardiovascular health. Exercise helps to control pain and increases confidence to take part in activities, which is important for socialisation and assisting the individual to take back control of his life and to reduce fear of movement,” she says.

The painful truth

▪ 20% of the adult population suffer from chronic pain – that’s one in five adults.

▪ This ratio increases to one in four for adults aged over 45 years and decreases to one in 10 for those aged between 18–24.

▪ 75% of pain complaints are related to musculoskeletal conditions such as arthritis, joint pains and fibromyalgia.

▪ 20% are caused by chronic headaches and migraine. 

▪ 5% are attributed to cancer, vascular diseases, poor circulation or injuries. 

▪ 86% of chronic pain sufferers lose at least one week of work a year.

Source: Malta Health Network, 2018