Saturday, 6 October 2007

yellow flag

hi everyone,
just thought I would share this little experience with all of you as I think many of you might have or will definitely come across similar situation like this.
I had a patient who came in with LBP and through subjective and objective examinations, he presented to have L4/5 disc pathology. I began treating him with lots of education, postural correction and local mm fascilitation. In the beginning, having come across similar patients before and I thought this would be pretty straight forward and easy however the patient suddenly became frustrated during the treatment and apparent he has been to physios prior to this episode and has been receiving similar treatments but has not been compliant with HEP prescribed nor advice given. His reason of not being compliant was because of the pain in the muscle spasm of the lower back so I told him to use a heat pack to reduce that spasm and he said he knows the fact that heat pack helps with muscle spasm but has not been using it.
I asked him why and he wasn't sure. The patient apparently is unemployed and is relatively young in his early 30's. I carried on with the treatment giving all the information he would require anyway and gave him new HEP which I doubt that he will be compliant with. new appointment was made and my question is, the only reason he is coming to physio was for the DTM to the mm spasm and obviously will not benefit from physio in the long term. Would any of you discharge him anyway if he continues to be incompliant?
Good luck with mid placement if you haven't had one already!

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