Today I had a conversation that I will have many more times over my career.
A patient came in because of his low back pain.
He had a history of back pain over the last 4-6 years that has been slowly getting worse.
The episodes of low back pain are occurring more times per year.
Each episode is lasting longer and getting more severe.
In the first few years the pain would last 2-3 days and the turn into stiffness for a few days.
He would be uncomfortable most of the day, but the dull pain was tolerable.
He would have a few sharp twinges or stabs of pain whenever he would bend, twist, or get up from a seated position.
But the pain would always go away on its own.
Over the years the episodes continued to get worse, the dull pain is getting stronger and lasting longer.
The sharp pain is getting more frequent and intense.
Sometimes the stabs of pain getting be severe.
He is getting more uncomfortable sleeping and sitting.
On average the episodes are lasting longer.
He is describing changes in his home and recreational activities by starting to avoid certain activities or perform less of them because of his back.
He is aware of how too much of any activity can flare up his back.
He is getting more sedentary and doesn't exercise like he did 5 years ago.
The examination was pretty typical, showing a lumbar sprain (low back sprain).
With a few visits he will feel much better and his pain will be less intense.
This episode will be over much shorter than average because of the treatment we are providing.
We reviewed a few exercises to do the next few days that will help with his pain.
I said there are exercises he can do a few minutes a day when he is better to reduce his chances of future episodes, and that I will show him when he is feeling better.
His response was a common one, "don't bother, I won't do them.
I'll just come back when it hurts again.
" I politely responded by giving him my 30 second talk on research showing improving muscle strength and pattern development can dramatically reduce the likelihood of future occurrences.
With his history he is very likely to see improvement.
The 30 second talk isn't a lecture.
I feel it's a responsibility to provide him with the information and let him decide what to do.
History tells me that I will be giving him this same 30 second talk in a few months.
Statistically we will be having this relationship for many years until he changes a few core habits and improves his muscle strength and coordination.
In the mean time, I am happy to help get him out of pain this week.
When he is ready and motivated to do the little things, I will be there to help him get rid of his low back pain.
A patient came in because of his low back pain.
He had a history of back pain over the last 4-6 years that has been slowly getting worse.
The episodes of low back pain are occurring more times per year.
Each episode is lasting longer and getting more severe.
In the first few years the pain would last 2-3 days and the turn into stiffness for a few days.
He would be uncomfortable most of the day, but the dull pain was tolerable.
He would have a few sharp twinges or stabs of pain whenever he would bend, twist, or get up from a seated position.
But the pain would always go away on its own.
Over the years the episodes continued to get worse, the dull pain is getting stronger and lasting longer.
The sharp pain is getting more frequent and intense.
Sometimes the stabs of pain getting be severe.
He is getting more uncomfortable sleeping and sitting.
On average the episodes are lasting longer.
He is describing changes in his home and recreational activities by starting to avoid certain activities or perform less of them because of his back.
He is aware of how too much of any activity can flare up his back.
He is getting more sedentary and doesn't exercise like he did 5 years ago.
The examination was pretty typical, showing a lumbar sprain (low back sprain).
With a few visits he will feel much better and his pain will be less intense.
This episode will be over much shorter than average because of the treatment we are providing.
We reviewed a few exercises to do the next few days that will help with his pain.
I said there are exercises he can do a few minutes a day when he is better to reduce his chances of future episodes, and that I will show him when he is feeling better.
His response was a common one, "don't bother, I won't do them.
I'll just come back when it hurts again.
" I politely responded by giving him my 30 second talk on research showing improving muscle strength and pattern development can dramatically reduce the likelihood of future occurrences.
With his history he is very likely to see improvement.
The 30 second talk isn't a lecture.
I feel it's a responsibility to provide him with the information and let him decide what to do.
History tells me that I will be giving him this same 30 second talk in a few months.
Statistically we will be having this relationship for many years until he changes a few core habits and improves his muscle strength and coordination.
In the mean time, I am happy to help get him out of pain this week.
When he is ready and motivated to do the little things, I will be there to help him get rid of his low back pain.
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