Chronic pain remains one of the most difficult diagnoses to treat. Over the years, various treatment styles have come through claiming to be the "fix" for chronic pain: McKenzie, core stabilization, dry needling, manipulation, etc. The current best-evidence approach incorporates much of what pain science research has revealed recently. One of the most important concepts for managing our patient's pain experience lies in educating them about what is pain and how the nervous system works. There are an enormous amount of factors that contribute to a individual's experience: work, family, finance, and much more. Explaining to our patients how these factors can impact them is essential. While the purpose of this article is not to teach you how to educate your patients about pain, there are plenty of resources out there. We recommend Explain Pain, Therapeutic Neuroscience Education and videos like the two shown below.
Another useful component for managing chronic pain includes graded exposure. Graded exposure involves gradually increasing the tolerance to certain activities that patients are afraid will "hurt." There's a lot more to it than that, but we recommend finding an activity or function that the patient is currently having a difficult time doing, but is one of the primary goals. We want to make it so the patient is even more motivated to work towards it. Next, you find different ways to gradually increase the exposure to those activities and increase the "tolerance." For example, if your patient is having a hard time walking and that is their goal. You may challenge them to simply focus on gradually increasing their walking distance each week. Don't tell them to focus on how much pain they are experiencing. Reinforce the goal of improving their function. Another method may be to alter the actual load gradually. Walking in a pool or on a body weight supported treadmill can be useful in increasing walking and aerobic activity, while not letting the patient's pain limit them. Over time, the body weight % can be increased, so that eventually they are walking further on land. There are many ways to address low back pain and each individual may respond differently, but patients with chronic pain can be a little more difficult to manage. Consider incorporating pain science education and graded exposure to your treatments. These patients do not typically have the same "mechanical" response as more acute cases. -Dr. Chris Fox, PT, DPT, OCS TSPT is now offering a comprehensive LUMBAR SPINE COURSEInterested in learning more about the lumbar spine?
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2 Comments
7/17/2024 06:38:43 pm
In the business world, travel is often necessary, and with it comes the risk of bad hotel experiences. These experiences can range from poor customer service to subpar accommodations, impacting a traveler's productivity and well-being. Businesses must ensure that their employees are booked into reputable hotels to avoid such pitfalls. Bad hotel experiences can tarnish a company's reputation, especially if clients or partners are involved. Therefore, investing in quality travel arrangements is crucial for maintaining morale and efficiency, ultimately contributing to a company's overall success.
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10/28/2024 12:53:28 am
Graded exposure therapy has shown promise in managing Lower Back Pain (LBP) by gradually reintroducing physical activity to individuals, reducing fear and improving mobility. Through carefully monitored exercises, patients can progressively adapt, helping lessen pain and reliance on medications. For comprehensive LBP management, lifestyle adjustments are essential, and in cases of associated weight concerns, some people opt to order Saxenda from Canada. This medication, along with graded exposure, can support weight loss, reducing stress on the lower back, enhancing long-term pain relief, and improving quality of life when supervised by healthcare professionals.
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