Therapy thoughts (15/7/25) Education for painful problems is VITAL

It seems like everything we do clinically is measured by how much it reduces pain. But I don’t think education is really about pain at all. Its about helping people make sense of the problem they have and to manage it better, both emotionally & treatment wise.  

We have to remember that uncertainty creates anxiety! And there is nothing like a bit of medical uncertainty to pour petrol on the problem. How long will it last? What is causing it? Will I still be able to do the things I want to do? 

Uncertainty and anxiety can lead to unnecessary test and investigations, and these will likely lead to more treatments and potentially worse outcomes. Something I say when I teach is “more is not better” when it comes to these things. We know this through research around this subject. 

 A great example is lateral elbow tendinopathy or ‘tennis elbow”. Both clinicians and patients can often expect it to get better in a few weeks, maybe a month or two. But this contrasts with the data which sees it last for more like a minimum of 6 months maybe even up to a year on average. 

 This can lead to poor decisions such as getting a corticosteroid injection that can often make the problem WORSE. This might be driven by an idea that as its not getting better then something else needs to be done, even though in reality it just takes longer than expected to get better. 

 So don’t see education as something that directly effects pain, that our explanations suddenly fix things. But they do affect the person experiencing the pain and how they may perceive the problem and the subsequent behaviours they may take. 

 If I am less scared and anxious about the problem, not worried about making it worse doing my usual activities & life, aware of a recovery timeline and what may affect that then hopefully it becomes easier to have the problem and not require more invasive tests and treatments. 

 When we see education through a lens of the person, hopefully we start to understand its importance.