This concerns my country prac and an Outpatient who I saw during my 4 week tenure. She was known to the PT department and I saw her for neck and shoulder pain. She was referred by her GP.
During the Subjective assessment it became apparent to me that she had a few yellow flags and she readily disclosed some psych issues she had(some of which had seen her institutionalised). There were no consistent findings with her reported neck pain with either the subjective or objective. Her initial response to AROM and PROM of the Cx region indicated severe pain though she appeared to have fairly adequate movement prior to the assessment from what I observed in the waiting room. Her shoulder movement was pain free and she informed me it was not an issue.
I discussed all this with my supervisor prior to commencing Rx. She gave me some good advice. I was to highlight to the patient the importance of compliance to the exercises I was about to prescribe. If she performed these exercises her symptoms would reduce and she would be over this ailment within 4/52. The exercises were ROM of the Cx spine, deep Cx flexor strengthening and postural positioning
The patient presented the following week with no pain, no limitation in AROM or PROM and her posture was notably improved with no chin poking and only minor Tx kyphosis evident. The convincing the week before had got across to this patient and whether or not she had performed her exercises I saw for myself pain-free movement and no restriction in all planes.
I believe that the more experience we gain the better we will become at treating patients who present a little differently! This patient was convinced she had a neck complaint. Rx strategies were used which emphasised the importance of self-management. Obviously my Supervisor knew this approach would prove favourable. I learnt alot from this experience and feel I could pick which patients would benefit from this approach.
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This approach was definately the best one for the patient. I hope with time and experience we will be able to judge on meeting patients which approach will be more benificial for them.
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