Radiology and Its Relation to Pain and Fear Avoidance Behavior

The Manual Therapist recently posted about different methods to address patients' perceptions on imaging. He calls them "thought viruses." As I've said before, one of the most frustrating things during an evaluation for me is when a patient can recite their imaging findings. It's not their fault. Often, multiple doctors and other health care practitioners have used a combination of the imaging findings, pain location, and biomechanical model to explain why the patient is having pain. With doctors' level of respect and how the biomechanical model "makes sense," it's no surprise that patients grab onto these explanations. Some of the things discussed in the article include the fact that degenerative changes almost always present in an asymptomatic population and that with intermittent pain, how the spine looks in an MRI doesn't change. Patients are often focused on the structural aspects and words such as "pressing," "pinching," or " crunching" have been shown to increase level of fear and pain in the brain by themselves. As a profession, we should stop reinforcing these outdated theories that may potentially even be harmful for our patients. Check out Dr. E's post for more in-depth discussion!

-Chris

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