As I was finishing my musculo prac I had to call any patients on my list that I had not seen during my prac to see if they still wanted some treatment or if they could be discharged. One man that I called had been seen once by the previous student about neck pain but had not returned since. I managed to call this patient who upon questioning whether he required more treatment said that he didn’t want to come back because last time he had gone home sorer than he had arrived. I further questioned him as to how he then went for the week after treatment and although the patient was somewhat vague on details he said that his neck had recovered back to normal by the following day but he could not say whether he had felt any better after this.
I therefore explained to him the side effects of post treatment soreness cue to manual techniques and that this was very normal. I suggested that he come in again, get some treatment and see if over the week it did indeed improve his pain levels, ROM etc. If it didn’t help we come try different techniques or again try to same technique but monitor responses over a longer time. I also explained how when dealing with a chronic disorder such as his neck it did take time and a number of sessions to have an effect on the pain and that he should not be looking for a miracle cure that is going to fix everything instantly. Treatment was an ongoing process along with self management to control the pain levels. The patient agreed to come back and try further treatment.
This made me more aware of just how important it is to warm patients of post treatment soreness and how first impressions are so powerful. This patient was willing to dismiss physio as a possible treatment all because he had some increased pain immediately post treatment and was not aware of what this meant. Anyone with similar experiences?
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4 comments:
hey kel, good work on actually getting the patient to come back in. the main issue with chronic pain patients is that pain, fear avoidence cylce and you managed to intervene at a really important time to educate and pursuade him to come in again. sometimes that's the hardest thing.
I also found that warning them is a wise step to take, especially when the next time they come in they complain about what you did because you forgot to give that simple warning. Lesson learned.
Good point, warning DOMS to patients is very important component of Rx. I had some patients who informed me as I mentioned this DOMS that they had received the instruction from previous students. I was very pleased that previous students were informing patients regarding DOMS. Good work, guys!
Yeah good call. Post Rx soreness along wit an explanation of why is something i now tell all patients i have freshly mobilised about as it a common side effect of manual therapy and the patients know not to worry
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