This is a summary of chapter XIV of “The Sensitive Nervous System” by David Butler. The Big Picture Evidence Based Approach Here is the step by step patient care process that Butler advocates. 1) Identify red flags and manage accordingly. 2) Educate on the whole problem to include tissue health status, the nervous system’s role, and test results. 3) Provide prognosis and make realistic goals. 4) Promote self-care, control, and motivation. 5) Decrease unnecessary fear and manage catastrophization. 6) Get patients moving as early as possible. 7) Help patients identify success and sense of mastery of a problem. 8) Perform a skilled exam. 9) Acknowledge that biopsychosocial inputs combine with the nervous system to produce pain and disability. 10) Use any measures possible to reduce pain. 11) Minimize number of treatments and contacts with all medical personnel. 12) Chronic pain may need a multidisciplinary approach. 13) Manage physical function and dysfunction. 14) Assess and assist in improving general fitness. 15) Assess how injury affects creative outlets and assist the patient with regaining creativity and discovering new creative outlets. Incorporating Neurodynamics There are several ways to incorporate neurodynamics into the patient’s plan of care which will be outlined below. Reassessment. Explanation. Passive mobilization. Active mobilization. Posture and ergonomics. Reassessment There are many evaluation protocols that warrant constant reassessment after applying an intervention. Be it a comparable sign or audit, neurodynamic tests can be utilized well within these systems. A word of caution with instant reassessment, as quick changes could merely be
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