Flash back post Spring 2017
Today was one of those experiences I will never forget. After a long day of treating at our mobile clinic in Ensenada, Mexico, we traveled to a man's house who was in such severe pain that he could not travel one block to see us at the clinic. Upon entering the house, we found a 35 year-old man who had not left his bed in 20 days because he had been diagnosed with a disc herniation and told to take medication and lay down until he was better. His symptoms had not improved in that time and he was very fearful about his future.
During his physical exam, we noted an extreme apprehension to move, elevated pain (10/10 per patient report), an absent achilles reflex, decreased motor output of the ankle and foot musculature and a spinal flexion directional preference.
We then spent nearly one hour educating this young man on pain, the importance of movement for pain modulation (spinal flexion biased movements) and the fact that many of these cases resolve with time and a simple graded movement plan.
After our two-hour session, his affect had completely changed, his pain had reduced to 5/10 and he was moving with increased confidence. We must never forget how important pain education, reassurance and language that promotes movement confidence are when interacting with individuals in pain. If you skip this portion of the session, your patient may end up spending 20 days on bed rest, like this man, and thinking all along that they are doing what is best for their condition.
If you are currently in pain, please let this post be a reminder to you to be an advocate for yourself. If a healthcare provider says something that makes you fearful or anxious or you think there may have been a misunderstanding, be sure to speak up, ask questions and seek a second opinion, if appropriate.