Physiotherapy to heal the pain of trauma stuck in the body

Traumatised clients tend to dissociate traumatic memory from feelings, as well as accompanying physiological sensations. Thus emotional trauma gets trapped in the body, often somatised in the form of chronic physical pain. The... [ view full abstract ]

Traumatised clients tend to dissociate traumatic memory from feelings, as well as accompanying physiological sensations. Thus emotional trauma gets trapped in the body, often somatised in the form of chronic physical pain. The high prevalence of chronic pain among traumatized refugees is well documented. As the pain matrix involves many aspects of the central nervous system, physical pain is rarely an isolated sensation, and is almost always accompanied by emotion and meaning. Psychological distress exacerbates pain perception. Physiotherapy for survivors of torture and trauma requires an integrative approach which considers mechanical, neuro- physiological processes, as well as psychosocial variables.


This presentation will describe a bio-psycho-social model of physiotherapy used in the treatment of a middle aged female Hazara refugee. The client had chronic pain low back pain and headaches. The resulting dysfunction limited her ability to cope with daily tasks. Pain limited movement and restricted her activities. She had difficulties with resettlement, including applying for a job. Physiotherapy aimed to help the client to learn to respond constructively to pain and to facilitate the flow of movement. A comprehensive range of conventional physiotherapy techniques such as joint mobilisations, soft tissue release, stretching and strengthening exercises, coupled with acupuncture / musculoskeletal dry needling and cardio-vascular exercise were implemented over a period of time to reduce pain and improve function. Specialised skills of facilitating body- mind awareness, breathing exercises and education on pain mechanisms were used to assist the client in understanding how the body stores unhealed psychological pain and distress. This, also, provided her with tools on how to prevent and release pain and work towards her own healing. Working collaboratively with the client’s counsellor augmented the process and improved her quality of life.