The Multidisciplinary Approach to Chronic Pain: Why One Practitioner Often Isn’t Enough

Chronic pain is pain that persists beyond three months — beyond the point where normal healing should have occurred. It affects a significant proportion of New Zealanders and is one of the most complex presentations in clinical practice. It is also one of the areas where a single-practitioner approach is most likely to fall short.

This article explains what the research tells us about chronic pain, why it is biologically different from acute pain, and why a team-based approach — like the one available at Velca in Howick — may offer more for people living with persistent pain than any single discipline alone.

Part 1: What Makes Chronic Pain Different?

When you sprain your ankle, pain serves a clear protective function. It tells you to rest, to offload the injury, to let healing occur. This is acute pain — it is time-limited and proportionate to tissue damage.

Chronic pain does not work this way. In persistent pain, the nervous system itself can become sensitised — a process sometimes called central sensitisation. The pain is real and it is not imagined, but it is no longer a reliable signal of ongoing tissue damage. Instead, it reflects an overactive alarm system that has become stuck in the on position.

This has important implications for management. Approaches that focus solely on the tissue — resting, protecting, treating the “injured” area — may not address the neurological and psychological dimensions of chronic pain. This is why a multidisciplinary approach is widely regarded as best practice for persistent pain.

Part 2: The Dimensions of Chronic Pain

Research consistently shows that chronic pain is influenced by multiple intersecting factors:

• Physical factors: Muscle weakness, joint stiffness, movement avoidance, and deconditioning. These are real and addressable, but rarely the whole picture.

• Neurological factors: Central sensitisation, altered pain processing, and nervous system dysregulation.

• Psychological factors: Fear of movement, catastrophising, low mood, and anxiety — all of which can amplify pain and reduce function. None of this means pain is “all in your head”; it means the brain and nervous system are involved in how pain is experienced, as they are in every pain experience.

• Social factors: The impact of pain on work, relationships, identity, and daily life — all of which feedback into the pain experience itself.

No single practitioner works across all of these dimensions. A physiotherapist addresses physical deconditioning and movement; a chiropractor may address joint mobility and nervous system function; a massage therapist addresses muscle tension and supports the nervous system through therapeutic touch. Together, they cover more ground than any one of them individually.

Part 3: What Each Discipline Offers

Physiotherapy

Physiotherapy for chronic pain is focused on restoring movement confidence, addressing physical deconditioning, and providing education about pain science. Rather than targeting a specific “injured” area, physiotherapy in the context of chronic pain often involves:

• Graded exposure to movement and activity that the person has been avoiding

• Strengthening and reconditioning exercises

• Education about the neuroscience of pain — often referred to as pain neuroscience education (PNE)

• Goal-setting around function rather than pain reduction alone

Chiropractic

Chiropractic care at Velca focuses on joint mobility, spinal function, and the relationship between the musculoskeletal and nervous systems. For people with chronic pain, chiropractic may:

• Address joint mobility restrictions that are contributing to movement limitations

• Support nervous system regulation through manual therapy techniques

• Provide a hands-on component to care that many people find supportive alongside exercise-based approaches

Massage

Therapeutic massage has a well-established role in chronic pain management. Beyond its mechanical effects on muscle tissue, massage has been shown to influence the nervous system, reduce cortisol levels, and support relaxation — all of which are relevant in chronic pain, where the nervous system is often in a heightened state.

Part 4: Why a Team Under One Roof Matters

When practitioners work in the same clinic, communication is direct. Notes, clinical impressions, and treatment responses are shared. Your physiotherapist knows what your chiropractor is working on, and vice versa.

This matters because in chronic pain management, consistency of messaging is important. If your physiotherapist is helping you gradually increase your activity levels and your other practitioner is advising you to rest, those messages work against each other. A coordinated team works from a shared understanding of your goals and progress.

At Velca, physiotherapy, chiropractic, and massage are all available in one clinic in Howick. You can access one or all of these, and your practitioners communicate as a team.

Part 5: What to Expect if You Come to Velca With Chronic Pain

A first appointment at Velca will begin with a thorough assessment of your pain history, your physical presentation, and how your pain is affecting your life. This takes time, and we do not rush it.

From that assessment, we will discuss what options may be appropriate for your situation. This might involve one discipline, or it might involve a coordinated approach across physiotherapy, chiropractic, and massage, depending on your presentation and your goals.

We will not make promises about outcomes. Chronic pain is complex, and anyone who tells you they can guarantee a result is not being straight with you. What we can offer is a thorough, evidence-informed assessment, a honest discussion about options, and a team that communicates and works together.

Want to find out more? Book an appointment at Velca in Howick. Our team will assess your situation and discuss what options may be available for you.

This article is for general information purposes only. It is not a substitute for advice from a registered health practitioner. If you have concerns about your health, please consult a qualified professional.

Velca Health Centre | 3/10 Wellington St, Howick, Auckland 2014 | velca.co.nz | 022 639 2705