Physical Therapy from the Patient Perspective
Nick Rinard is not only a colleague whom I hold in high esteem, he is also my physical therapist! I’d like to share with you 5 things that I found interesting about my experience being a patient at our clinic:
- The verbal reference scale for pain: It is very difficult to assign a quantitative number to pain level! Pain is such a variable experience, that reducing it to a 2 or a 4 just doesn’t completely describe the character or behavior of the symptom.
- Assigning a score to functional difficulty: I was stumped when Nick asked me to rate the difficulty of a daily task. I now understand why so many patients struggle to respond concisely to the question.
- The power of touch: Trusting someone to handle your painful body part can be daunting. However, I found the confidence and surety of Nick’s steady hands to be very reassuring. I was able to quickly relax and allow him to passively move my ankle and foot.
- Listen before acting: I had to direct my mind to an attentive listening mode rather than an anticipatory listening mode. By this, I mean that if I was constantly attempting to guess what Nick’s next instructions would be, I was keeping my mind occupied instead of open. Being a physical therapist, I had to step away from my usual role of planning the care, and instead actively listen so that I could follow Nick’s lead.
- Expect greatness: Before seeking help, I had been limping around for two weeks stubbornly trying to ignore my pain. I was skeptical but hopeful that Nick could help me. I should have expected greatness – by the next day, I was already noticing positive improvements in my gait!
Thank you for your help, Nick! You are the physical therapist of choice for this physical therapist!
Margo Burette, PT, DPT
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Low back pain is one of the most common causes of disability in the world. A recent study found that “Out of 291 conditions studied in the Global Burden of Disease 2010 Study, LBP ranked highest in terms of disability (YLDs), and sixth in terms of overall burden.” With a large range of different types of back pain it can be extremely frustrating finding relief from this type of pain.
Luckily there has been a large effort to find the best approach to dealing with low back pain. A 2018 study comparing healthcare costs for patients with a diagnosis of low back pain between the ages of 18 and 64. Interventions studied included differences in opioid prescription, health care utilization, and timing of PT intervention. This study found that patients who saw a PT at first had a lower utilization of high‐cost medical services (MRI, surgical intervention, emergency room visits) as well as lower opioid use.
Another study looked at the differences in long term outcomes in patients with spinal stenosis given PT or surgery. The results of this study after 2 years found that patients “did not differ significantly between patients who had undergone surgery and those who avoided surgery.” This shows that physical therapy alone is a much safer, cheaper, and equally effective choice.
Understanding your back pain and using your own body to fix itself has proven to be the least expensive and best outcome tool when dealing with low back pain. Therefore be your own advocate when dealing with new or recurring back pain and try PT first!
Frogner, B. K., Harwood, K., Andrilla, C. H. A., Schwartz, M., & Pines, J. M. (2018). Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health services research.
Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., & Murray, C. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, 73(6), 968-974.
Minetama, M., Kawakami, M., Nakagawa, M., Ishimoto, Y., Nagata, K., Fukui, D., & Sakon, N. (2018). A comparative study of 2-year follow-up outcomes in lumbar spinal stenosis patients treated with physical therapy alone and those with surgical intervention after less successful physical therapy. Journal of Orthopedic Science, 23(3), 470-476.
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