Henry,
You make a good point here, certainly giving someone a label can lead to worse symptoms. Why does this happen? Partly because the patient is now using the diagnosis as a reason for feeling the way that they are feeling - therefore initially they may feel it is "ok" or acceptable to you and the medical profession to be experiencing all these symptoms. After all, it was you who gave them this diagnosis. Also, their symptoms worsen because the power of suggestion is so stong to the human pysche. This often works for us in the clinic, not against. It's amazing how many patients get suddenly better once you tell them that their knee/back/neck etc. injury isn't serious. Often patients with CFS of FM have read a little, or know someone with it - therefore they may relate to what they read, or to the friend etc. with the condition. This is a form of comfort, being able to relate to another, and may provide an emotional security that previously the patient did not experience.
However, I don't think we should throw away the terms at all. We as medical professionals need to approach these patients differently. I must say, I have made 3 or 4 diagnoses of FM, all of whom responded very well. Why? Because that is where I take my hands off - I tell the patient that the ball is now in their court. Physio is not proven to be an effective treatment for these conditions - what is proven in the literature is aerobic exercise, gentle stretching and strengthening, and amytriptaline anti-depressants. I often give them a hydrotherapy program, advise on walking, and show them specific stretches to target problem trigger point areas. Then, I only review them occasionally. This does not allow them to use their label as an excuse for their symptoms, but empowers them to do something about it themselves. Thus I take the focus off the label, and place it on a positive outlook and lifestyle changes that will help. That has been my experience anyway.
---
Scott Epsley
PHYSIOTHERAPIST
Northside Sports Injury Centre
Brisbane, Australia.
e-mail: [log in to unmask]
On Tue, 24 Apr 2001 09:49:12
Henry Tsao wrote:
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