A large number of patients that we see suffer from chronic pain syndrome, problems that won’t go away and that continue to haunt them on a daily basis. These presentations are often variable in intensity, going from really severe down to minimal or even no pain. Often when these patients present the history is very unclear – they will often remember when they started to suffer from the pain but not how or why it started.
Unfortunately, for many patients, they’ve gotten to the point where they feel overwhelmed and out of control of the presentation before they show up to see us.
For the majority of these cases, they have retracted away from many of their daily activities and feel that simple things like housework or going to work will make them worse. When treating these sorts of cases, our first goal is to identify where they are breaking down, what are their weaknesses, what are their imbalances?
By doing a systematic analysis of these people, we can identify the key issues and develop targets for our treatment and exercise interventions. In most of these cases, the clients are not doing any regular exercise. As a result, initial exercise programs may seem trivial and start as something as simple as 2 minutes of walking, 2 or 3 times a day.
The prime goal with managing these cases is to be systematic. We need to understand what makes people worse, what makes them better and how do we develop a routine that will get them back to where they want to be. Formulating hard targets of what they want to achieve in specific time frames. Additionally, getting a diarised understanding of what makes them worse and what makes them better is a good start for us to put together their treatment plan.
These cases require comprehensive assessment. Many of these clients have had multiple X-rays, often of the same area. The question you need to ask yourself is, if you have already had four sets of X-rays done of the lower back and nothing has changed, why would a new X-ray show anything different? And if it did, why would that mean that was the reason for the pain? Because, remember, you have had these scans done before, and that problem wasn’t present, but you already had the pain. Clearing up these myths is one of our prime goals, and then giving people hope, clarity and direction will normally move them down the path of getting a result.
When planning these sorts of cases, we would normally be looking a 6-12 months to recover. Unfortunately, if a problem has been there for ten years, the likelihood of a resolution in days or weeks is highly unlikely. It takes some dedication and structure to re-train the system. If you have a chronic complex case that you would like us to review and assess, please call us and we can look at developing a treatment plan to help you achieve your result.
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