And the evidence rolls on……
Source: Clinical tests to diagnose lumbar spondylolysis and spondylolisthesis
Month: August 2015
Mulling over Mulligan’s musings…
A kit bag of fancy tricks or using the system of assessment & force progression which directs loading required. Hmmm choices….
Translating Pain
Seamus Barker philosphising on pain. Another take worth considering!
The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’
Just make sure that the bases are covered!
The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’.
Alarm Bells
Sometimes some of the simplest explanations are the best. As the late, great Robin McKenzie would often say, just listen to the patient, they will always give the cues! Thanks Blanaid
From our good friend Blanaid Coveney:
Buying some time
Most people know how hard it is to explain pain to patients especially … well … when they have ongoing pain! The endless touring of different clinicians and specialist clinics in pursuit of a cure is common. Ingrained belief systems mean that hunting for the source of the pain is often a driving force. Explaining pain can be tricky and from time to time can lead to a patient heading for the hills never to be seen again. You can nearly see yourself losing them in slow motion. Anything which makes it easier to explain pain is always welcome. On occasion you may come up with something which resonates with the patient and buys you time so you can gradually introduce new concepts which may challenge/change the patient’s belief systems.
“Chronic”
The other day, one happened by chance. A patient and I were chatting. He has ongoing pain. I can never say the word chronic to…
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“Tell me like it is, Doc” – What to say when you need to tell someone their pain is probably ongoing
30 years ago sounds like not long but in neurophysiology terms perhaps a few lifetimes. However some of the principles still hold true. A good insight!
About 30 or more years ago I was diagnosed with chronic pain. I’d had low back pain for a couple of years and I was finding it SO hard because of my work in Older Person’s physical rehabilitation. I had treatment after treatment with no change in my pain. I had an X-ray that told me I had a “transitional” vertebra. I thought this explained why my pain persisted and I was hoping someone would be able to “unstick” this vertebra and my pain would be gone. I was referred to a chronic pain management centre and the wonderful Dr Mike Butler, Rheumatologist and pain specialist there told me “There isn’t a medical answer to your pain problem.” Luckily for me he didn’t leave it there – he suggested I read The Challenge of Pain by Melzack and Wall.
But I will admit, I walked away from that appointment feeling…
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Neil Wise Physio 