As the chronic pain physical therapy specialist at our hospital, I was asked to speak with the newly admitted chronic pain patient on our rehabilitation floor. The program is designed to help get a patient moving as much as possible and to help the patient wean off of drugs if that is a goal they have chosen. Those treating this patient were looking at her through a standard physical therapy lens.
A full evaluation was done yesterday and the patient was sufficiently flared up to make it difficult to touch her. I performed some relaxation and gentle manual therapy techniques and the muscle spasms started to decrease. I told her that the “no pain no gain” philosophy was not mine and we would go slowly. That helped her to relax some more.
We had a great first session and trust was the result. There is a big difference between chronic and acute pain. With acute pain patients, you can address the problem directly and then fix it. With chronic issues, trust is even more important. Gentleness in treatment is also crucial. If you scare someone away at first, you may not get another chance to gain their trust again.
Treatment of all types of pain should not be the same. You can’t fix chronic pain with a quick manual therapy treatment or a few modalities. It takes slow, small steps and lots of patience.
February 6, 2009 at 1:04 am
Couldn’t agree more. Chronic pain is definitely a different approach to acute pain.
I think your point about building the trust is crucial, and making sure you come away with a small win after the first visit definitely helps.