Normally, a patient in severe pain, that is acute and insidious onset has a severe loss of ROM, right?
There is good news, and good news regarding this severe loss of mobility.
First the good news
- since pain alters motor control, the mobility loss is a motor control issue
- we can educate the patient that the motion is there, the brain is just doing it's job and protecting you at this point
- translation, if we modulate the pain, the mobility will return
Now, the good news
- it's an ACUTE loss of ROM
- as in, if they had the mobility immediately prior to onset, the mobility is STILL there
- no time for true "issues in the tissues" to form
- I often tell the patient, "You have the mobility, you just do not know how to access it, or are currently in protective lockdown."
- so no scar tissue, adhesions, etc, or things we cannot change rapidly
Remember, rapid onset = rapid resolution in most cases as long as there is no true macro trauma that requires healing. If you are patient enough, choose a novel, non-threatening intervention, your patient's mobility will return in full rapidly.
Keeping it Eclectic...