Rehabilitation management of the chronic pain-hypertension synergy: Proposal of an evidence-informed framework

Background

Chronic pain and hypertension (HTN) have a significant societal impact worldwide. Both lead to consumption of substantial healthcare resources and dollars. The pathophysiology of chronic pain and HTN are each complex and multifactorial. Chronic pain has been associated with an increased risk of comorbid HTN. There are numerous common factors related to the development, progression, and prognosis of patients with chronic pain and HTN. Though the cardiovascular and pain regulatory systems are structurally and functionally intertwined, the exact physiological interactions between chronic pain and HTN are less understood. Many systems, including the central and autonomic nervous systems, play a role in the development and interaction of these two complex conditions. In collaboration with other healthcare providers, physical therapists play a critical role in managing those with chronic pain and HTN.

Objectives

This masterclass aims to develop physical therapists’ knowledge and understanding regarding 1) the epidemiological and physiological relationship between chronic pain and HTN, and 2) screening, examination, and management of the patient with chronic pain and HTN, including appropriate referral.

Discussion

Improving understanding of the relationship between chronic pain and HTN should assist clinicians in appropriate management strategies for such patients. Physical therapy should be an essential component in the management of patients with chronic pain and HTN. By collaboratively addressing both health conditions, there is a window of opportunity to play a role in mitigating the burden of these conditions and promoting a healthier society.