As many of our regular followers are likely aware, the progression of pain science research has revealed not just the fact that tissue pathology is not correlated with the pain experience, but also the impact of biopsychosocial factors. These factors can be from a variety of sources. A patient's home life, work concerns, cultural beliefs and more can impact how a patient experiences an injury.
Recently, I was speaking with Dana Tew, PT, DPT, OCS, FAAOMPT of Optim Manual Therapy Fellowship about some new studies that came out. While the level of evidence is not as high as we would ideally like, their findings can still suggest some interesting things. One of the things many manual therapy classes teach is to educate your patients on how exercises can help them. A recent study on ultrasound showed that if the therapist positively described the benefits of ultrasound to the patient (compared to the controlled group of no education), then the patient exhibited an improved SLR! While no changes were found in pain, the fact that our words can potentially impact neural tension and mobility is impressive. Another study looked at a patient's expectations of physical therapy and their likelihood of success with physical therapy. It found that low expectations of physical therapy were more correlated with decision to undergo surgery than any anatomic features. I definitely can identify with this one as I have had some patients come in for physical therapy simply because they were told to by their doctor or insurance. Even with education and improvement with conservative treatment, these patients tend to pursue surgery. Regardless, the significant thing taken away from these studies is that the importance of the mind on our treatments appears to be reinforced. Not only can it impact pain, but also neural mobility and chance of success with PT. We should be certain to use these studies when educating our patients.
-Dr. Chris Fox, PT, DPT, OCS
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