We all have the patients that are obsessive over their diagnostic imaging findings. They are fearful for you to even evaluate them without reading their MRI reports. Some of the most distressing words we hear as clinicians can be, "have you seen my imaging reports?" Immediately, the patient is at risk for becoming a slow responder due to the presence of perceived threats from the reports. Recently, I had a patient who had an MRI that revealed some disc herniation in her lumbar spine. I tried to educate both the patient's family and another involved health care practitioner on how disc abnormalities can be normal in teenagers and twenty-year-olds as many are asymptomatic with those same problems. No matter what I said, there was a level of fear in that patient's family (likely heightened by the confirmation from the other practitioner) that could not be shaken. Recently, a study came out showing just how common disc bulges can be. Between 70-78% of asymptomatic individuals in their twenties have a disc bulge in their cervical spine. This further increases the evidence of how it is a normal aging process. The fear instilled by imaging can be difficult to treat. It is by far my weakest area as a physical therapist. I used to think it would apply to a small population, but it appears to become ever more important with the progression of pain science. I currently am reading Therapeutic Neuroscience Education and have read Explain Pain in order to develop my methods of educating patients on pain science. What other sorts of resources or methods do you use in this area?
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