Over the last 20 plus years of being a Physiotherapist, I have lost track of the number of times I have heard this comment from patients ‘’I thought it would just get better’’, soon followed at the end of the consultation by ‘’I wish I had come sooner’’. In my clinic yesterday, I had 4 new self-funding patients who all said exactly the same thing -I therefore felt compelled to write a blog on this topic.
I understand why it happens, some of the common reasons include: –
- People are busy and it can be seen an inconvenient to have to take time out of your busy schedule to see a Physiotherapist (or other health care professional).
- It can be difficult nowadays to get an appointment at your local GP surgery (if you want to go down this route first).
- You might not know who to go and see and don’t want to risk spending money seeing someone who might not be able to help you.
- You do a google search, self-diagnose a problem and do some exercises recommended on google or YouTube (due to convenience and to save money)
- A friend or family member ‘diagnoses’ your problem and gives you advice.
Whatever the reason may be, when I assess a new patient, its not uncommon for them to have had the problem for several weeks if not months. Now, its important to state that the natural history for quite a few of the common musculoskeletal (MSK) conditions out there, is good. Lets take low back pain (LBP) for example (the most common problem we see at Thorpes Physiotherapy). As long as there isn’t nerve irritation or something more sinister going on, evidence shows that the vast majority of mechanical LBP should be significantly better within 6 weeks time. I agree with this statement, however I would add, as long as the patient is doing the right things within these 6 weeks
and not doing things (often with the best intention) that might be irritating or prolonging the problem. For example, with an acute episode of LBP, there is often quite a lot of muscle spasm in the low back. In this early stage, a common mistake I see is that the patient is often overly stretching their back (having seen some exercises on google) or started doing pilates or yoga (when they are still in pain) -or doing regular, deep self-massage (with a tennis ball) which may be irritating the problem in this acute stage. The opposite of this (too much rest) is often equally as troublesome as this can create stiffness, weakness, and fear avoidance behaviour. Each individual is unique, and
the advice, education and treatment offered is tailored to the individual.
Another common example is a tendon problem (let say the Achilles tendon). A patient may have increased their walking or running a little too much, too soon and irritated their tendon as it inserts on the heel bone. In this acute (reactive) state, the tendon needs relative unloading to help it settle. What I commonly see is that the patient has been doing stretches and heel raises over a step (as they saw that advised on google), which often makes things worse in the acute stage.
When someone has had a problem for a long period of time, things can become more complicated. What started out as a relatively straight forward injury in the initial stages can become more chronic, scar tissue can develop, muscle imbalances can occur and cause knock on effects elsewhere in the body. Also, if pain persists for a long time, then peripheral or central sensitisation of the nervous system can occur (which is more complex to treat).
The more I do this job as a Physiotherapist, the more important I feel getting an early diagnosis and prescribing the APPROPRIATE advice and education is. For lots of straight forward MSK problems, people often don’t need much in the way of Physiotherapy. If they know what the problem is and how to best manage it, then the problem heals well and we don’t get these complex issues of more chronic injuries.
All my new patients yesterday said that they had wished they had seen me sooner. Some of them had convinced themselves the problem was worse than it actually was, and felt relief when I discussed the diagnosis and positive prognosis. Others reflected and said that they had been doing all the wrong things and had been making it worse (even though they had the best intentions). Getting an accurate diagnosis can often ease lots of stress or worry. Understanding why a problem has occurred and having clarity on what you should and shouldn’t be doing is so important -and this needs to come from a trained health care practitioner who has assessed your particular problem
(not from google or a well-meaning friend or relative).
At Thorpes Physiotherapy, we understand the reasons why someone may be hesitant to book in. If you are not sure if Physiotherapy can help your problem, then you can book a FREE discovery phone call or discovery visit, which enables you to speak to a physio first and for us to establish if we think this is something we can help you with or not.
If you would like to speak to one of our team, please call 01276 37670 or alternatively you can book online by clicking the button below.
I hope you have found this interesting and please make sure you are being proactive with your
health.
Warm regards
Jonathan Smith
Director of Thorpes Physiotherapy