You are a junior physiotherapist to whom Michael, a 56-year-old male with chronic lower back pain, has been referred.
Michael reports having experienced this back pain for 2 years, and it has got progressively worse. Six months ago, he left his job as an office clerk as he was simply unable to sit at a desk. He doesn’t believe he will ever get back to work and reports feeling quite pessimistic about the future. He reports the pain is ‘continuous’. It keeps him awake at night. On a good day its ‘6/10 pain’ and at its worse ‘10/10 pain’. He takes a strong cocktail of medication which he reports ‘takes the edge off temporarily’
On physical assessment he is very tense. You think initially he would benefit from some gentle hydrotherapy. You refer him for an 8-week course and arrange to review him after.
When he returns, the hydrotherapy department reports he turned up for just 4 sessions. He claims to have had no improvement and wasn’t satisfied with hydrotherapy being the outcome of his first consultation.
You take this opportunity to write a 1,500-word reflective piece for your continual professional development portfolio. In the report you must:
- Examine the qualities and dimensions of pain- for example the difference between the chronic pain Michael has, and acute pain (AC3.1)
- Analyse 2 theories of pain (AC3.2)
- Explain how Michaels social and emotional experience may affect his pain management (AC3.3)
- Evaluate the universal 1-10 pain scale used by Michael to assess his pain (AC3.4)
- Discuss the pain management options available for Michael (medical, behavioural, cognitive) (AC3.5)
Then, thinking about how you approach your follow-up with Michael:
- Discuss the behaviour and style adopted by both patient and practitioner and their effect upon interactions (AC4.1)
- Analyse why you think Michael may not have been compliant with hydrotherapy (AC4.2)
- Using research, describe how could you a) improve Michael’s understanding of and b) improve his satisfaction with his physiotherapy (AC4.3)