Friday, February 24, 2012
The Road to Better
Here is a quick post about changing someone's attitudes and some of the strategies I use in the clinic.
Pt has chronic history of HA and cervical pain, works in a hotel night shift at the desk. She looks downward at 3 monitors for most of her 8-10 hour shift. Seemed like a simple enough case, correct posture, IASTM to cervical paraspinals, give her a lumbar roll cervical retractions.
Four-five visits in, she still has mod to sev soreness in cervical spine and HA. We seemed to be just another provider in her long list of the sea of experts she had seen in the past. On visit 6, we focused a bit more on upper thoracic, traps, and told her to really hammer away at her exercises at work.
Visit 7, she states, she is still very sore (that's the extent of her subjective), however she states she has not had a HA since last visit, which was 4 days. I said, "That is GREAT! You are getting better!" She agreed.
Today she came in finally saying herself she was slightly better.
This is what I call breaking the "pain, not better cycle"... they may need some convincing, because only PTs get excited about posture, ROM and function, but once they truly believe they are better, they tend to steadily improve after. We focus on any improvement seen in a positive, encouraging atmosphere.
Another patient in chronic pain with TMD and HA used to come in every day saying how bad she felt. I simply said, "I want you to tell everyone who asks you how you are doing that you are doing GREAT!" She practice a few times before she said it with any kind of resolve. She then started on the road to better instead of telling everyone how poorly she was feeling all the time.
Last clinical example, a patient yesterday who was doing about 80% better in terms of HA, cervical and facial pain came in yesterday after having a stressful day. She stated she was back to square 1 and had severe pain and HA. After a normal manual treatment, all of her pain was completely abolished. We educated her that during an acute flareup, it is easiest to treat it and get back to baseline. If she truly went back to square 1, we could not have resolved it entirely in 1 visit.