One of the most difficult issues about treating patients with chronic pain is that they typically don't respond to manual treatments and exercise the same way more acute injuries do. Those with acute injuries will often have significant changes in pain, mobility and more either within treatment or within a couple days. A patient with pain that is chronic in nature requires a different treatment approach. Education plays an essential role with these patients. With the lack of correlation between pain and structural pathology, part of our role as physical therapists is to make sure our patients do not get dragged into the state of mind that a pathological diagnosis can be assicated with and instead empower them to become aware of the link between various parts of their brain and their pain. Following the initial evaluation, I often give my patients a pain questionnaire to assess their initial beliefs on their condition and prescribe that they watch the 2 videos below in order to initiate discussion at follow up visits. Some additional beneficial resources include the books Explain Pain and Therapeutic Neuroscience Education.
-Dr. Chris Fox, PT, DPT, OCS
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