Along the lines of spinal psychology - my acute OPD colleagues are
starting to get very interested in yellow flags here and aim to prevent
their patients ending up on my chronic pain management books.
They seem to assume I know all about it as I work with a psychologist,
but I haven't a clue when it comes to acute stuff.
So a few questions from them -
1. If you have an acute patient, and you're identifying yellow flags,
what do you do about it - apart from realising that your patient is not
going to be "cured" in a hurry?
2. Also, does anyone have any ideas about how to screen for patients who
need more than the usual acute OPD treatment without subjecting them to
a battery of psychological tests? We're looking into a flow chart which
involves various questionnaires at various stages of a patient's
progress, but so far it looks like they're going to spend more time
analysing the paperwork than treating the patient (who is going to spend
more time filling in questionnaires than they spend with the physio.)
3. The other issue is that staff are a bit concerned about becoming
"amateur psychologists" and feel that standard physio training doesn't
adequately equip them to deal with some of the issues. Should we be
saying that junior physios shouldn't treat backs because of the complex
psychology of back pain, and they could be doing more harm than good by
perpetuating fear of movement etc? or is there a quick way to get the
important information over to them so they treat their patients more
effectively earlier in their career?
Sorry if this sounds a bit woffly but acute practice isn't my forte, and
I know that some of you out there are experts in this sort of thing.
Regards,
Carol David
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