Open the link to see all ‘7 steps to successful patient empowerment’
– all text taken from the link –[Therapist]: Well, as you can see from your x-ray here, there is some degeneration in your spine. This is wear and tear and quite normal for your age. Furthermore, your examination reveals lumbar joint restrictions, gluteal trigger points and your back muscles are somewhat weak. This kind of back pain is completely harmless, and nothing we cannot fix with some therapy and exercise.
“If exercise makes you better, your problem must have been weak muscles.” “If joint manipulation helps, then restricted joint movement is to blame.” “If soft tissue work gets the job done, surely the pain origins from tight muscles.”
The human brain is notorious in wanting to establish association between observed events. It is also terribly bad at it. As a result of our reluctance to deal with cognitive dissonance, we patch our patients up with one hand and stab them in the back with the other.
The psychosocial components of back pain are now so clear-cut that the modern clinician has no choice but to adapt his or her practice accordingly.
We know that fear-avoidance predicts worse outcomes (8). We know that weak sense of self-control and poor confidence in performing activities are even stronger predictors of future disability.
– We all agree we want our patients moving.
– We all agree we want them not to worry.
– We all agree we want them to stay optimistic.
– We all agree we want them to take charge of their own health and wellbeing.
Then, why do we keep priming them otherwise?
4. Sidestep the allure of flawed bio mechanics.
Patients with erroneous bio mechanical understanding of pain do worse. Don’t worsen this understanding by assigning causation to the trigger point or the joint restriction. If you lack the pain science knowledge to replace these explanations – giddy up.