Can seeing a therapist make your pain worse? As much as I hate to admit, I think so.

Recently, I listened to a very interesting TED talk and I encourage you to watch its entirety here. The main idea was that people tend to latch on to negative events much longer than positive ones. It takes greater time and effort to convert losses to gains than to convert gains to losses, the presenter explained. We experience temporary highs and long periods of despair, thus getting stuck with the negatives.

If we consider that physiotherapy is highly interactive, therapists should be very wary of their manners and behaviour towards the patient. Take communication, for example: a relatively simple diagnosis with good prognosis can be misconstrued as debilitating or requiring a lot of treatment, thereby planting a negative notion of disability and loss on the part of the patient.

About half of my current patients have had negative experiences with physiotherapy and have consequently stopped treatment, choosing instead to live with chronic pain. Of course, this only perpetuates the feeling of hopelessness, so when I suggest to them that I can help, they are both grateful and surprised, if not a little skeptical. The recurring theme with these poor experiences was a therapist who was not giving enough individual attention, listening intently, or modifying the approach when improvements were not evident, all of which stemmed from booking too many patients in the same time frame. By neglecting care and ignoring the needs of the patient, the therapist prolongs the recovery process and makes the pain chronic. So in fact, a negative physiotherapy experience can be much more harmful than not doing anything at all. A good therapist, I argue, should be someone who can provide that lift when a patient is hurt, to rebound from the loss as quickly as possible.

Sadly, I have listened to people describe their despair with physiotherapy far too often, but I wish for that to change. If you are one of these people and have not found physiotherapy beneficial, don’t give up. You should seek a therapist who involves you in the treatment and actively works with you throughout the entire rehabilitation process. You should always (with some exceptions) feel a gradual shift in responsibility from passive care to total self-care upon discharge. If you don’t feel that you are being cared for, let your therapist know. If your treatments aren’t working, ask what can be done differently. And if nothing changes still, move on.

Avoid getting stuck in the negative. It takes a great deal of effort to shift from a negative to a positive, but it is definitely possible. It is what truly caring physiotherapists excel at doing.

Categories: Patient care

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