Whilst on my country prac I was treating a patient in the outpatient department who was suffering from a sprained ankle. She had sustained this injury a year ago and she was convinced that she had fractured the medial aspect of it. The x-rays indicated no fracture! She also had a referral for a lower back complaint. Over the coming weeks she would improve at one stage and then come back in 3 days later and report 9/10 pain. Yes I went through the pain scale with her, explained it etc. She didn’t look like she was experiencing 9/10 pain. Anyway amongst her other medical history it was written that she suffered from fibromyalgia. Could this explain her high levels of pain?
The senior physio was a gun and knew her stuff. She came in to the last few appointments I had with this patient because it was getting confusing and not following the script I would have thought it should. The senior suggested one day we look at the patient’s lower back. The assessment I carried out and treatment was performed accordingly. The senior and I would see her in 2 days time. She came back worse off. I had no idea what to do with this lady and the senior was ‘stumped ‘ also. We gave her 2 more appointments before the senior decided to refer this patient on. She explained to the patient that maybe she needed to go back to her GP as PT intervention was not helping her condition. It was actually quite a ‘release’ to hear someone say that especially the senior because I regarded her as a very good physio, she had at least 10 years in the profession and she had taught me quite a lot during my time there. The patient agreed with this course of action.
This act taught me a lot. If PT intervention is not helping a patient then there is no point wasting anyone’s time and more importantly delaying some further investigations which may need to take place.
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