Dear Di & Michael,
No doubt psychosocial issues become involved in every chronic injury, but
why such an emphasis on chronic back pain patients versus chronic pain in
other joints?
I have seen PT's who work on young patients- athletes- who are chomping at
the bit to return to play, but cannot due to actual pathologies. What group
do they fall in? I say neither- they have the desire to return to play and
most do not have large resposibilities. I don't know how anyone can tell a
patient that most people get better in 6-8 weeks, and if they're not better
yet... put them in one of these 2 groups to figure out what's "wrong" with
them. What about the group of patients that have had long standing
mechanical problems with other multiple acute pathologies that have brought
them to therapy. As much as PT's hate to admit it, the body does not heal
itself in 6-8 weeks when underlying muscle imbalances, malalignments, and
the such exist often no matter what treatment approach one employs. I'm not
saying all patients, but I think our profession does not want to admit that
many of the 10% of patients who don't get better fall into this category.
My point: don't use psychology as a cop out for unsuccessful therapy. We
don't know enough about the back- diagnosis & rehab- to do that to every
patient with chronic back pain. It's great to believe in what you do and
believe that it works, but nothing is foolproof and every patient is
different!
Jill K.
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