Whilst on my musculoskeletal placement, I had a patient who had an acute back strain, they came in to see me about 3-4 days after the initial incident caused by picking something up off the ground and they were still in quite a lot of pain and had symptoms into the anterior thigh as well. So the first thing was to do was to decrease the pain and this was going swimmingly with both the back and thigh pain decreasing, i was happy with this progress as it would mean i could progress to more manual techniques which would hopefully help the patient continue to recover.
I was seeing the patient twice a week and on about the 3rd week the patient arrived and when i went to get them from the waiting room i could see they were in quite a bit of discomfort. On questioning the patient they said that they had been doing quite a bit of squatting and bending at work and the pain was back up to the level of the original incident if not worse. I was quite upset about this and with the patient as they were progressing so well and for this to occur was quite a shock to me. We were back at square one and back to the main focus being to decrease the patients pain.
On looking back at the situation i think i could have been more understanding of the patients situation as it may have been necessary for them to work and it may have also been partly my doing as even though i did specifically tell the patient to avoid flexion type activities, through my response to the improvements I may have given the wrong idea about where the patients recovery actually was at.
I THINK IF I WAS IN THIS SITUATION AGAIN I WOULD TRY TO GIVE THE PATIENT MORE INFORMATION ABOUT WHERE THEY ARE IN TERMS OF THERE RECOVERY AND EVEN THOUGH THE PATIENT HADN'T DISCUSSED THERE RETURN TO FULL ACTIVITY AT WORK IN FUTURE I WILL TRY TO BE MORE CLEAR ABOUT WHAT EXACTLY IS APPROPRIATE IN TERMS OF THE PATIENTS RECOVERY AT WHATEVER STAGE THEY ARE AT.
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I think your right more education was definitely require, so the patient knew what activities to avoid or how to do these activities without hurting their back. I think sometimes we forget how much knowledge we have and assume that patients know the same benefits and risks as we do. So from your experience and my own it is safer to just assume the patient knows absolutely nothing, and if they do have a little knowledge on the topic it never hurts to emphasise particular points.
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