Treat the Person, Not the Diagnosis

Rethinking How We ‘Fix’ Pain

When we get injured we want to know what is going on. We want a diagnosis. Makes sense right?

However, when pain hangs around for longer than 3 months, is working with a diagnosis the best way to go?

Before you start thinking, well yes of course it matters… Let us take a few steps back.

When you experience pain for greater than three months, your initial injury has become more than just an injury. It has become the reason you have pulled back, stopped doing activities you love, stopped doing chores around the house, stopped playing with your kids or pets OR for a lot of people all of these, plus feelings of frustration and confusion.

So while this pain started as a diagnosable injury, it has now become an injury within a much larger context of issues.

We see it time and time again when someone is experiencing persisting back pain and you ask how bad the pain is. They may say a 2/10 which is usually followed by yeah but I know it doesn’t seem like much but it stops me from doing so many things as I am worried it will get worse.

The fear of re-injury or fear of flare-up is such a big part of experiencing persistent pain.

Learning how to build up confidence and trust your body again becomes the primary goal for so many people in this situation. This is the focus of our Pain to Performance program. To give you the confidence and the ability to get back to the things you love to be doing.

So yeah a diagnosis is nice but when it comes to treating persistent pain it isn’t everything. A big study confirmed this recently looking at results from 61 different studies where using education and exercise interventions were effective for reducing fear avoidance behaviours and especially fear around movement. (Martinez-Calderon et. al, 2020)

Not only this, but the highly prestigious and recently updated ACSM guidelines for exercise for lower back pain recommends de-emphasising a patho-anatomical diagnosis and focussing instead on other factors, saying “The best available evidence supports a classification approach that de-emphasises the importance of identifying specific anatomical lesions…” (ACSM 2020) (To read more on this, read our blog on the guidelines for treating lower back pain)

Understanding what is holding you back when it comes to movement and getting the most out of life is way, way more helpful as this will form the foundation of your plan and journey.

So back to my main point. When it comes to treating persistent pain, treat the person, not the diagnosis and you might be surprised at how much progress you can make.

References

American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription

Martinez-Calderon J, Flores-Cortes M, Morales-Asencio JM, Luque-Suarez A. Conservative interventions reduce fear in individuals with chronic low back pain: a systematic review. Archives of physical medicine and rehabilitation. 2020 Feb 1;101(2):329-58.

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