What does working with a Pain Coach look like?
Treating people with persistent or chronic pain is often not as straightforward as treating and rehabilitating someone who has had an injury. The latter usually have a more predictable outcome depending on the injury type. For example, we know a ligament sprain will take somewhere between 4 and 6 weeks to recover. and A hamstring tear may take anywhere between 2 weeks and 3 months, depending on the severity and location.
Chronic or persistent pain often does not have such a strict and measurable timescale as many factors influence this, such as:
- the chronicity of the problem,
- response to previous treatments, including medication and physical therapy
- the person’s awareness of what pain means and how it is produced
- the therapist’s ability to relate to the person’s story and create a good rapport
- other lifestyle factors within the patient’s life such as mental health issues, social structure and support systems, family dynamics, and work fulfillment.
These can all have a degree of varying influence on the individual’s pain and their specific response to the treatment of their pain.
We know that treating chronic and persistent pain is a speciality area within medicine and physiotherapy. Due to its complexity, it requires a more holistic and multidimensional approach that works on the physical, mental, emotional, spiritual, and even philosophical nature of the injury or condition. The key to a more desirable outcome is the interaction between the therapist and the patient.
Often patients have seen many physiotherapists and other healthcare practitioners and have struggled to find clarity in their understanding of their condition or injury. They can also show a lack of direction and a map detailing how the therapist can help achieve a successful outcome.
How does working with a pain coach for persistent and chronic pain look?
Below we have outline how working with a Physiotherapist and Pain Coach may be different from other experiences you may have had.
At Complete we work on these 5 main principles.
1. Time
Most physiotherapy sessions work on a 45-minute initial and 30-minute follow-up sessions. For persistent and chronic pain cases, we allow an hour for initial and a minimum of 45 minutes for follow-up sessions; one-hour sessions are desirable.
This is because these cases have a deeper story attached to them than straightforward injuries, and as your coach, we want to hear your story in full. It gives you the space and time to express and me the space and time to listen. This is really key, and one of the biggest frustrations patients have is that they don’t feel listened to. Time makes that more possible.
It is also more of a process rather than having strict time-driven goals. We do set goals, but the margins for achieving those are a little more flexible than a simple physical injury. Recovering from chronic or persistent pain can be a lengthy process, and it is important that patients must have realistic expectations of this.
2. Education
Much of the work done in dealing with persistent or chronic pain is around education. Without an understanding and education of some of the factors affecting this, it is tough to raise your level of awareness of your problem. We will usually suggest some reading material, something to listen to, or something to subscribe to to help you gain more clarity around the chosen subject.
3. Work between sessions
Just like you would be prescribed physical exercise to do as part of rehab for an injury, so too will we prescribe both physical and mental exercises to do as part of your case. For the mental exercises/questions, we use a document that you can edit and share back with me. As you fill in the questions we can see what you have written, and we can then add further questions, or we often refer back to it in sessions to explore what has been reflected on. This acts as a hub to our work where you can look back, amend and add things as you wish, and it means we have somewhere to add things too.
4. Deep questioning
Part of treating chronic or persistent pain is an exploration of what else might be driving certain patterns of behaviour which in turn can be driving physiological change and vice versa. My questions are different from regular physiotherapy questions, which often rest on physical pillars. We will look at all possible facets of a patient’s life and, with permission, delve into areas that perhaps have not been explored.
One of my aims is to try and offer an alternative way of thinking which may then lead to a change in mindset. Quite often, chronic pain patients live in the land of black and white, yes and no; by alternative questioning, some grey and openness can come into their world.
5. Patient driven recovery
Our job as a Physiotherapists and Pain Coaches is to facilitate and guide your recovery. We cannot change your way of thinking for you and give you the answers all the time. It is important that, together with the patient, we support what will work best for them. Of course, we will offer advice, education, ideas, and my opinion on things, but ultimately we are led by what the patient is going through and how together we can work towards the desired outcome.
It is less prescriptive than a traditional physio/patient relationship. It is a very humanistic and empathetic approach that responds to how the patient shows up throughout the process.
We have found that treating chronic or persistent pain requires a unique approach, and by combining the skills and knowledge of a physiotherapist and a pain coach, we can help you achieve your goals.
If you would like to book an appointment with me, call 020 7482 3875 or email alexmanos@complete-physio.co.uk
Don’t let pain hold you back, book now!
