Therapy thoughts (6/10/25) - What’s the number one way in which I help my patients?

What’s the number one way in which I help my patients?

Its super simple actually, so simple that many people don’t even consider it!

Improving confidence.

It's likely not very complex or sexy for most people. There must be more to it right? I personally don’t think so. It would be great if we could magically take pain away first visit, but unless it’s your first day at the office you know that this is very unlikely for 99% of problems.

One of the biggest reason people want to get help (yes, also the pain) is that they are worried about the problem. How long will it last? What’s causing it? What can we do about it?

This highlights the need for positive psychology to run through all the things that we do, from interaction to examination and treatment. This is probably contrary to a lot of rehab encounters that tend to increase fear and nocebo!

We know that a predictive factor of recovery is, low expectations of recovery! This is well evidenced across a bunch of MSK problems.

Let’s take exercise as an example. It’s a great way to embody our positive messages around movement. Not just telling people but also showing them. A fancy term for this is experiential learning.

They might experience that moving with a bit of pain is OK, it doesn’t make the problem dramatically worse. This can reduce the interference that pain has on our lives, which often reduces the stress and worry too.

As we worry about these things less, I think they do seem less impactful. We can cope better. Does this mean the pain goes away? I am not sure currently, maybe for some people.

Maybe as we return to normal behaviours a bit quicker, being a little more confident, our bodies natural mechanisms kick in and help.

Pain self-efficacy is a technical way of measuring confidence, sort of. I don’t think they are totally the same concept but are definitely in the same ballpark.

Maybe it’s about thinking less technically sometimes and a little bit more humanly. Pain is a funny beast that doesn’t always play by the biomedical rules.