Exploring the Principles that Define Our Approach
A Comprehensive History: The Key to Succesful Care
Effective pain management starts with a thorough history and clinical exam, covering the biological, psychological, and social aspects of pain. This involves deep conversations about your personal story, past and present symptoms, family health history, lifestyle factors, and your thoughts and beliefs about pain.
Dedicating more assessment time to a detailed clinical history enhances the physical exam by highlighting key areas to concentrate on.
From Symptoms to Diagnosis: Establishing an Early Impression
From the provided information, we form a working hypothesis about your condition. While this is not the final diagnosis and might change with more data, it is a crucial starting point that guides further investigation.
Provocation Testing: A Dance with Discomfort
In orthopaedics, provocation testing helps identify musculoskeletal issues by deliberately stressing the affected body part to induce symptoms. This method pinpoints the underlying triggers of a patient's pain.
Using physical stressors like compression, tension, or bending, clinicians closely monitor patient responses, noting the characteristics, intensity, and onset of symptoms to identify their nature.
Reframing Pain to Fashion Positive Health Behaviours
At SpineLab, we see compassionate, personalised symptom understanding as the key to effective self-management. Our approach merges patient experiences with scientific research.
Instead of using complex medical terminology that might cause anxiety, we prefer terms like "sensitised" to ease concerns. If a detail is not helpful or changeable in the treatment process, we might opt not to discuss it.
We opt for clear diagnoses like "bending or compression intolerance" to simplify symptoms and highlight that they can be addressed or changed.
This approach boosts confidence by turning complex issues into straightforward, applicable solutions.
By reframing pain and teaching symptom modification, individuals can confidently manage their pain, even if its exact cause is unclear.
This encourages a proactive approach to healthcare, freeing individuals to self-manage their symptoms and enjoy movement again.
Moreover, we prioritise integrating positive lifestyle habits to lessen pain sensitivity and ease emotional distress, ensuring individuals stay engaged in activities they value.
We can include more specific details, like medical imaging or blood tests, when they become clinically important, especially for individuals with unexpected treatment responses.
The Role of Medical Imaging in Pain Diagnosis
Many patients believe medical imaging is essential for pain diagnosis, but this is not always true. In fact, most guidelines discourage early routine imaging for simple back pain.
A 2013 study revealed that getting an early MRI for acute low back pain, when there is no specific medical reason, does not help and can even cause psychological harm, leading to worse outcomes.
While medical imaging is a valuable diagnostic tool in healthcare, providers should weigh its pros and cons. By using these tools wisely and only when needed, they can offer the best care for their patients.
SpineLab, as a healthcare provider, adheres to evidence-informed practices and exercises caution when ordering diagnostic tests, such as medical imaging, for musculoskeletal pain. We generally avoid requesting imaging within the first six weeks of care unless there is a clear indication, as we are aware of the potential risks and negative effects of unnecessary testing.
However, there are instances where certain indications observed during a patient's examination may necessitate further diagnosis before the six-week guideline. In such cases, we may request imaging to enhance our understanding of the condition and develop an appropriate diagnosis and treatment plan.
Report of Findings: Integrating Diagnosis, Planning, and Treatment
For straightforward diagnoses, we often share our findings and start treatment immediately. However, when more testing or treatment planning is needed, we will report our findings upon completion of these steps.
