How Painkillers Work
NSAIDs (ibuprofen, naproxen), paracetamol, and opioids reduce pain through various pharmacological mechanisms. They are genuinely useful — particularly for acute pain management and enabling participation in rehabilitation. However, they treat the symptom of pain, not the structural or functional problem causing it.
The Problem with Relying Solely on Medication
When pain is masked without addressing its cause, patients continue activities that perpetuate the injury. Chronic painkiller use carries risks: gastric complications, kidney stress from NSAIDs, opioid dependency, and the progressive deconditioning that results from avoiding physical activity due to unresolved structural problems.
How Physiotherapy Is Different
Physiotherapy addresses the cause of pain — whether it is a weak muscle allowing a joint to be compressed abnormally, a tight tissue pulling the spine out of alignment, or a movement pattern that places excessive load on a specific structure. By solving these problems, physiotherapy achieves lasting relief.
The Evidence
Multiple systematic reviews have shown that physiotherapy is as effective as surgery for many conditions including meniscal tears in knees, spinal stenosis, and shoulder impingement. For chronic low back pain, physiotherapy significantly outperforms long-term opioid therapy in functional outcomes and quality of life measures.
The Best Approach: Combination
Short-term pain management with medication, combined with active physiotherapy, provides the fastest and most lasting recovery. Painkillers enable movement; physiotherapy restores function.