Osteopathic treatment and management is not just about the issue that the patient is concerned about at that moment. It is about the factors that lead them to this point and the journey they will be on to get out of it. It is important that the practitioner gets to know the patient as a person, not an injury, so they can work with the patient, rather than forcing them into plans that they aren’t motivated to complete. By doing this it helps the practitioner diagnose the problem and guides them in what will be appropriate for the patient’s management plan and allows them to do as much as they can to prevent it from happening again. To achieve this, the Osteopath will ask questions – some of these may seem irrelevant. The purpose being to find out the real reason why you have sought out an Osteopath, the reason the patient themselves might not be aware of.
This can be around the injury itself, such as ‘what are you feeling?’ and ‘when is this happening?’, to questions around how this makes you feel and what you think is stopping you from progressing forward and becoming pain free. These open questions allow for the formation of a partnership between the practitioner and the patient, to explore and exchange information in a positive environment. This is a part of a counselling process called Motivational Interviewing which is designed to help people find the motivation and reasoning to make a positive behaviour change.
As a patient, it can be a frustrating process having to repeat the explanation of the problems in thorough detail. Experiencing pain can be overwhelming, and often presents with emotions of anxiety and depression, and trying to communicate this to someone else can be difficult. By further questioning the issue, both the practitioner and the patient get clarity, which can help decrease the sensitivity around the situation and give the patient back their control. This is also about helping the patient understand the mechanism and behaviours around the issue. Questioning someone’s understanding of the situation allows the Osteopath to get a better idea of the patient’s belief system and how that will affect their prognosis.
Once progress is made in the management plan, and the patient is able to perform functional movements without pain, focus can turn to what can be done to prevent further injury. There is no magic pill to prevent further pain and injury, however it is possible to change certain behaviours to reduce the risk in everyday life. The impression can often be that these ideas revolve around ‘perfect’ technique, or lifting things ‘wrong’. With open discussion we can discuss an individual’s lifestyle, including diet, general exercise and stress, to collaborate on a future plan to make positive change. These changes need to be long lasting and effective so it is important that the patient and their circumstances are the centre of that conversation, not the practitioner’s preferences.
During the consults, the patient might not be aware most of this is going on. This is happening while talking about AFL results and favourite coffee spots, and even these answers are considered important. For if the patient is struggling to exercise, and an achievable option is to walk the long way to the coffee shop, that is a win for both the patient and the Osteopath. It can be hard not to get frustrated with all the questioning, but the more open both parties can be towards each other, the better the outcome for everyone.
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