This is a summary of Chapter VII of “The Sensitive Nervous System” by David Butler. Education When it comes to patient education, there are four things that every patient wants to know: 1) What is wrong with me? 2) How long will it take to get better? 3) What can I do for it? 4) What can you (the clinician) do for it? When we do educate, we must not forget that pain is a biopsychosocial phenomenon and multifactorial. The onion skin model below provides a good relationship analogy for this. The first goal addressed in education is making the patient understand pain. Patients must realize that pain is the defender, not the offender. It is our body’s way to perceive a threat. Therefore, we must quell this fear before focusing on function. Here are some suggested ways to describe pain in non-threatening ways. Back trouble. Neck discomfort. Twinges. Feelings. When obtaining pain information from our patients, this is something that we do not have to measure. Instead, it is important to look at variables associated with pain, namely. 1) Geography & nature, aggravating/relieving factors, links. 2) Mechanism of injury. 3) Explore how patient’s classify their symptoms (e.g. my joints are worn out), and ask why they think the symptoms still persist. 4) Consequences of the pain. 5) Coping types. 6) How the patient relates to pain (do they get angry or play the blame game). When determining treatment course, instead of focusing on the structure at fault, look at
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