Hey everyone, Im on my prac at SCGH and every Wednesday afternoon we have a staff continuing education session. This involves either one of the Physio’s who work in the hospital or guest speaker giving a talk on a topic of interest. Last week one of the Physio’s who works in the musculoskeletal outpatient field gave a very interesting and informative talk on pts with chronic pain so I thought I would share with you all some of the things she had to say. Basically she made it very clear that chronic pain pts are very difficult to treat as they have so many other issues contributing to their problem and therefore we should never attempt to deal with these pts on our own. Successful treatment of these pts usually requires input from the multidisciplinary team as their pain is so crippling all aspects of their lives are affected by it (work, relationships, family dynamics ect.). The physio explained that it is important to appreciate that although the pt may not demonstrate any known pathological condition their pain is real and we need to acknowledge it, however it is crucial that we as physio’s do not reinforce the pts passive attitude to their situation. That is we need to encourage the pt to be as active as possible and to try to be independent in every way that they can. The physio pointed out that this can be a difficult task in the inpatient hospital setting as you just don’t have the time or specific skills to achieve this. The fact that all the other members of the health care team may not be sending the same message to the pt can also compromise the situation. The physio therefore stressed that these difficult pts need to be identified early and if possible referred to a physio with a better understanding of chronic pain and a good knowledge of the techniques required to treat this clinical gp.

This physio runs an outpatient 5 week program at charlies for pts with chronic pain that includes exercises to treat the pts impairments and hopefully improve their function as well as lectures that aim to change the pts attitude towards their condition. The program is very much focused on trying to get the pt to take a more active role in trying to fix the problem rather than always opting for the ‘hands on treatment’ or the ‘quick-fix surgery.’ For the program to be successful the pt has to be motivated and committed to making changes to their situation, unfortunately many of the pts fail to put in the effort and drop out of the group before the end of the 5 weeks.

After hearing this talk I wondered are we as fourth yr physio students really equipped to deal with these pts? I personally don’t feel very confident that I would be able to manage a pt with chronic pain effectively and think that perhaps some more information and practical application focused on this clinical gp would have been very helpful throughout the course.