This week on my musculoskeletal placement I had a patient come in with a diagnosis of Adhesive Capsulitis (frozen shoulder), who had been referred from their GP. Upon reading the previous students notes it became clear that this patient was within the 1st/2nd stage of the pathology. Therefore I knew before even meeting the patient that they would be in a considerable amount of pain.
When I met the patient they said their pain had decreased since the last physio session, so after an brief assessment I decided to do the same treatment as the previous student. Then 3 days later the patient returned for another physio session however after the subjective assessment it was very clear that they were in more pain than the previous session. This didn’t surprise me as I knew that with this certain pathology during the inflammatory stages there is little that physio treatment could do to relieve pain. This particular day I could hardly touch the patient as everything was ‘too painful’. The patient was a little confused as to why they hadn’t improved like the last physio session.
So for the patients benefit I spent half of the treatment session explaining the stages of a frozen shoulder and how the 1st and 2nd stages were focused on relieving pain and that they would have to wait for the pathology to ‘run its course’ before they could start getting better. At the end of the session the patient seemed happy with the session and said they would continue to come to the physio treatment sessions.
FROM THIS EXPERIENCE I HAVE LEARNT THAT YOU CAN’T ASSUME THAT JUST BECAUSE THE DOCTOR HAS WRITTEN A DIAGNOSIS ON A REFERRAL FORM THAT THEY HAVE FULLY EXPLAINED THE PATHOLOGY TO THE PATIENT. PATIENTS REALLY DO APPRECIATE SOMEONE TAKING THE TIME TO EXPLAIN THEIR PATHOLOGY. NOT ONLY DOES THIS HELP COMPLIANCE WITH PHYSIOTHERAPY, BUT IT ALSO PREPARES PATIENTS WHEN A THINGS DON’T GO THE WAY THEY PLANNED.
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On the contrary...I recently had a pt with frozen shoulders bilaterally that she's had for nearly 2 years,so no pain anymore. It was interesting talking to her during the session because unlike your patient, this lady knew absolutely everything, she had done heaps and heaps of research,( as you would if you were only in your 30s and had it bilat for a few years). I would imagine since the internet came out, people have better access to info (whether its correct or not).Don't be surprised if patients know more than physios do regarding their conditions
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