2 More Ways To Motivate After a Flareup | Modern Manual Therapy Blog

2 More Ways To Motivate After a Flareup

Just as patients are thrilled when they rapidly improve, they are often equally if not more disappointed and anxious when they have a flareup or regression.

You've often read my standard "Your complaints just flared up? Great news! Rapid onset normally equals rapid resolution. It's a good thing you came in so quickly!"

Here are two more ways to motivate a patient during a flareup and prevent catastrophization

Scenario 1: Assuming a patient has progressed, and especially rapid responding after several visits, then they worsen for whatever reason....

"Don't worry, if you had pain for a much longer time, and we still improved you rapidly, there is usually no reason why we can't just do it again!"

  • unless there is actual physical trauma, an exacerbation can normally be dealt with rapidly
  • instruct them to double down on their MDT based HEP if they flare up and if there is no effect, give it some time
  • if in 1 day it does not rapidly improve with HEP/rest, call and we'll get you in ASAP
Scenario 2: If it was a patient who already been through step 1, or just did their HEP and/or rested appropriately and they came in better than the flareup

"This has been a great test of how well you're improving! Prior to PT and education, your flareups would last -insert longer time here- Now, it only lasted 1-2 days and you're already getting closer to the baseline prior to the flare up. Great job!"
  • any regression after improvement is worrisome for most patients
  • it's also part of our job to encourage and provide realistic expectations
  • part of those expectations are knowing how much is "too much too soon," or don't give on the HEP too early
  • it just happened today when a chronic pain patient had flared up after shovelling some lovely Buffalo, NY snow
  • at first she was going to call and try to get in, instead she located some spots along cervical patterns that I normally worked on, had her husband press on them
  • by the time she came back, her arm pain was centralized, and she was almost back to baseline
  • she said, "Instead of freaking out, I just tried what you normally do to me."

Bonus motivator:
  • I often describe some patient's ups and downs on a visual graph
  • "You have ups and downs, but if we drew a graph plotting them, it would go steadily upward, indicating overall improvement."

Now go out there and ease some anxiety!

Keeping it Eclectic...

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