- MRI’s and X-rays aren’t reliable sources of information about the causation of pain or the best path of moving forward.
- Chasing pain is hardly a way to fix it.
- You weren’t given the most accurate reasons for what’s going on or a way to change it.
- Schools, Programs, etc teach techniques, modalities, therapies, philosophies, how to get degrees and credentials, etc., but they don’t teach practitioners to become effective at being client-centric. Without knowing it they became self-centered rather than client-centered.
- The therapy or the exercises you were told to do didn’t have much relevance to your chronic pattern.
Persistent low back pain is a big problem. Most of the time it can be resolved, but why are our healthcare systems, techniques, and practitioners having such a difficult time treating it?
A LOT of people who come to me have been trying to figure out their persistent low back pain problems. And a lot of people suffer for decades without much relief, after having seen the best practitioners, tried multiple therapies, and still don’t understand Why. Why?
This is one of my biggest interests, because at this point, it just doesn’t make sense. It doesn’t need to be this way.
If you’ve been suffering for a long time, I want to help you. Hopefully this read is a good start.
A Problem With Scans
If you’ve had MRI’s and X-rays you might’ve been given some ideas about why you’re hurting. Let me ask a question, Was that evidence helpful to reduce your pain, did it create more pain, or not do anything at all? Just a question, whatever the answer is, note that. Note how information actually makes you Feel. Information IS important, it has an impact. You might say it’s psychological, a placebo, etc. The point is that it has an impact. The type of impact it has really needs to be considered, especially if it’s negative.
Some people feel worse. Others feel hopeless. Others are neutral. Others want to know what to do next now that there seems to be something that can be done. The problem is, it’s complex.
I’ll put some sources below, but for now the most conclusive evidence is that MRI’s and X-rays really don’t help us know the cause of pain and they don’t really help clarify a way forward. Well, that sucks. Yeah, if you’re someone who has put lots of trust (and you should) into the healthcare system, that sucks.
If you live in chronic pain it may have changed your life. Or the lives of the people around you, like your kids or your spouse. Maybe it has made work a worse experience than it could and should be.
One thing is that there’s hope in what’s not working because it points to what can work. The interpretations we get from scans aren’t very reliable in and of themselves. They tell us a part of what’s going on but the entire puzzle put together in its truest way is always gonna be better than just a small piece, which a scan is.
Chasing Hurt
If we were legos we could replace a hurting part with a new one and all of our problems would be solved. Fixing pain even as simple as rubbing, pounding, massaging, needling, foam rolling, etc., the part of your body that’s hurting. Where pain is usually isn’t where you need to go to solve it.
Pain is always only a small part of a bigger story of what’s going on in us than we were once led to believe. The International Association for the Study of Pain says that pain is always both a physical and emotional experience. That may sound really woo-woo to people but no, it confirms the reality that there are multiple aspects to a human being.
So, chase symptoms, and get lucky, great! If you’re not so lucky and your symptoms persist, look deeper.
Why Only Focus On A Part Rather Than The Whole Picture?
25 years ago alternative medicine practitioners were still seen as really weird. Eh, ok. I got into this because mainstream medicine didn’t help me. Now into my 26th year of practice and with science and data being where it is, it’s really clear to me that 2 things: A person’s history and who they are are really more important than a single symptom.
Understanding the whole picture also gives a clear path out. Treatment typically only addresses that a therapist is doing now, but the bigger picture should include a strategy of moving forward, goals, ideas, things to implement, etc.
I believe, early on in the client/practitioner interaction clients should say things like, Wow, no one ever showed me my problem in this way . . . this makes sense. That response is what the whole picture can do. Pain is like anything else, the more you understand the better you can prepare, organize, and make moves to the end result you want.
From Self-Centric to Client-Centric
When the great people of the past invented the therapeutic techniques we have today, they selflessly taught them. And that was the right thing to do at that time. They did their best to bring to the world the help it needed.
Today we’re in a very different place. Yes many of those techniques are still valid, but we know better when to use what, with who, and when. If we follow the latest science we can help people more than ever. The evidence is out and we should go with it.
In general, techniques and therapies work but not in isolation. What I mean by the Self-Centric Model is that practitioners push their modality without good evidence, but because that one technique is what we Do. The system is broken and people suffering bear that burden.
Being Client-Centric is about better understanding pain and how to apply the swath of information to the person in front of us to get the results they want. We’re not taught to do this in school. It’s much easier to stick to traditional curriculums and to teach age-old techniques, then graduate people with certificates (that are mostly status symbols) because that’s cool. If you’re like my clients you care less about status symbols and you want your life back. Hum, makes sense to me.
Pain problems will shift when clients and practitioners both are willing to embrace new ways of doing therapy.
The Therapy, The Homework, And The Information Should Be Easy To Understand, And Relevant.
As an example: Have you gone somewhere where you were given a piece of paper with exercises for you to do at home, without really understanding why you’re doing them? And did they help? Most of my clients say, No.
Or, if a massage technique helped, did your therapist give you an explanation why? If not, I find it strange. But even worse, it’s typical. And I believe it’s because most don’t have a decent explanation to give about helpful mechanisms. If they did, and could show you what you could do or how you could do something similar at home, would that help?
The feedback that I get from clients is that the homework I give them is certainly helpful in moving forward. It should be. But I’ve done a lot of back end work. I had to close gaps between what I learned in school, what I learned in practice, what I understand in science, and put things together that resulted in good outcomes.
It’s so much easier for practitioners to apply their techniques to symptoms – Oh, that’s a really tight muscle – and then they attempt to hammer Tightness out, even though science says it doesn’t necessarily work that way. Instead practitioners should check in to see if it’s something that is right for the client. Practitioners should be taught to look for guiding evidence that could help their choice of therapy, education of the client, and homework (if they give any), that would make for much more successful outcomes.
What’s characteristic of good therapy and good homework is that they should make sense given Your History And Who You Are. For instance, if you’re having neck pain and your neck is constantly in a forward position, getting your head and neck back is probably going to be important for therapy and how to do that well could be given as homework.
Because pain is the number one reason people seek help and there’s a lot more great science to help us we should have fewer surgeries, we should have better education, and better ways to develop practitioners. I’ve worked with many people who have had pain for long periods, even decades after near death experiences and they’re doing much better. If you’ve been suffering longer than you should have, let’s chat, here’s the like to schedule a quick talk https://medicinevolution.as.me
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