Experience the difference in management provided by physiotherapists with expertise in treating chronic pain.

Highlights:

  • Providing the patient with enough time to tell their full story and collaboratively with the Physio, identify the most important issues that are limiting recovery
  • Treatment directed at cause of symptoms and not just symptoms themselves
  • Functional assessment and treatment, targeted at addressing the issues the patient has raised.

A new mum and retail worker was first seen by our physio nearly five months after her initial wrist injury. In the 19 weeks previous to her appointment, the patient had received an anti-inflammatory injection and was also immobilised in a wrist splint. Unfortunately, the patient reported no improvements in her pain and disability levels and felt that her overall condition had worsened.

During her initial consultation with the Physio, the patient was allowed enough time to tell the story of her injury and how it was affecting her life at the moment. In partnership with the patient, the Physio was able to identify the main barriers to recovery and the issues that were most important to the patient. These were:

  • Development of shoulder pain due to not being able to use her arm properly
  • Unable to perform normal work duties
  • Difficulty lifting her child, performing house duties and dressing herself
  • Anxiety about further damage to her wrist and the threat of permanent disability

Following the subjective examination, the Physio was able to convince the patient to remove her wrist splint so that a physical examination could be performed. This examination found that:

  • The patient was unable to lift anything heavier than 5kg
  • Was not able to perform repetitive gripping activities
  • The original injury had healed well but due to the associated joint stiffness and upper limb disuse, there was ongoing pain and disability in the wrist and shoulder

Treatment during the initial consultation concentrated on manual therapy techniques to address the wrist and shoulder joint stiffness, as well as education around managing pain without immobilising the wrist in a splint. The patients grip strength improved from 7kg to 25kg within the first session and her wrist and shoulder movement improved significantly. Home based exercises were also prescribed, concentrating on wrist and shoulder movements as well as beginning some basic strength exercises.

Additional to her ongoing physiotherapy treatment, a visit to her workplace was organised to address the work related causes of her pain, and not just treat the symptoms over and over again. Changes were made to her computer monitor, keyboard and mouse and guidance given on lifting techniques to protect the wrist.

Following further management and consultations with the Physio, the patient was able to perform her normal work duties, home duties and lift her three year old again without pain.