Skip to main content

Every little thing a nice therapist does is magic

“Everyone has some therapist they swear by, either a chiropractor or a physiotherapist or a massage therapist,” a patient once told me. “Everybody’s got their guy.” It’s true, almost everyone who has been through a lot of chronic pain has tried several therapists and sooner or later settled on someone as their favourite. Many times in my own career as a massage therapist I became someone’s “guy.” I often replaced the previous guy. I was never quite comfortable with that, because I know just how misguided that loyalty can be. People like physical therapy whether it works or not. In 2010, researchers dug through thousands of scientific papers, looking for the ones that tracked both the effectiveness of treatment and overall patient satisfaction: An unexpected finding was that treatment outcome was infrequently and inconsistently associated with patient satisfaction. Unexpected? Ha! Hardly. There is a glaring disconnect between the effectiveness of a treatment and how a patient feels about it. Satisfaction is determined by social and psychological factors far more than anything else. The social and presentational skills of the therapist are what influence patient satisfaction, not the treatment results. Every little thing a nice therapist does is magic — or seems like it, anyway. Consider the widely-reported fact that patients don’t sue doctors they like, regardless of how badly the doctor may have screwed up. The best legal insurance for a doctor is simple, genuine charm. Similarly, a patient who likes a therapist will almost never conclude that treatment was “useless” … even if it was. But it goes much further than that … Still in pain, still enthusiastic! Patients are really quite magnanimous: they will often graciously describe an ineffective treatment as “amazing,” as long as they like the therapist providing the service. Indeed, almost everybody who has “got a guy” seems to still be in pain! This is especially true of chronic back and neck pain. Their symptoms might be reduced, but they still have “bad back,” they are still nervous, they still have days when their back “goes out,” they have a list of verboten activities, they are perpetually unable to wrestle with their spouses, give airplane rides to their kids, or snowboard, or run like they used to, or whatever, all for fear of a fresh attack of symptoms. Not such a great life. Not much of a cure, really. But they’ve got their guy! He's “totally amazing.” The testimonial falls from their lips without irony. People can do these mental gymnastics with great skill and endurance. It’s easy for primates: the social dimension is everything to us; we are far more social than we are rational. I never wanted to be anyone’s guy, or at least not until they have actually gotten better — really better, by a reasonable standard of success, a standard that wouldn’t be a disappointment to anyone outside the box they’ve been living in. It’s true, when you’ve had chronic pain, any progress can be a godsend. But c’mon, people: is it really necessary to “swear by” a treatment that hasn’t done any more than take the edge off? Can’t we just say you’ve “got a guy who helps a little”?

Popular posts from this blog

PF-ROM Exercises

"Pain-free range of motion’ or early mobilization exercises can help you heal" PF-ROM is physical therapy talk for “pain free range of motion.” When a therapist evaluates an injury, he or she will be interested to see how far you can move affected joints without hurting. Sometimes, of course, you can’t move at all without pain. But in most injuries, even many serious ones, you will have at least some painless movement. And whatever you’ve got, you should use. When you are hurt, the pain-free range is your new best friend: that’s the range you’ll be exercising in for a while. Pain free range of motion exercises are also known as “early mobilization.” Use it or lose it “Use it or lose it,” they say. And it’s true. While many seemingly simple medical questions are controversial, this one appears to be straightforward: plenty of recent research demonstrates that early mobilization is A Very Good Thing. A 2006 study of people with surgically repaired achilles tendon ruptures sh...
Read more

Don’t waste your money on expensive trainers

Expensive running shoes offer no benefit in terms of cushioning impact and overall comfort compared with 'cheap' trainers, reported The Times and other newspapers on October 11 2007. The researchers found that “no amount of built-in air bubbles, shock absorbers or other cushioning makes a difference to the overall pressure on the foot.” The stories are based on a study that compared the performance of low-, medium-, and high-priced running shoes in men while they were walking, and in a smaller group who ran. The interpretation by the newspapers that this study has shown that expensive trainers do not protect runners’ feet is not quite accurate as the “running” part of the experiment was small and the researchers themselves state that “it was not possible to reliably detect differences between pressure in shoes from different brands and across cost ranges”. Importantly, the participants in the study were normal runners. They didn’t have any gait abnormalities such as over or ...
Read more

Being overweight

"Four million people died in 2015 as a result of being too tubby, struck by cancer, heart disease, diabetes and other killer conditions," reports The Sun. This is based on a global study that looked at how the proportion of people who are overweight and obese has changed over time. This was determined by recording body mass index (BMI), where a BMI of 25-29.9 means being overweight and 30 or above is being obese. Researchers then assessed the link between having an unhealthy BMI and health outcomes including cardiovascular disease, diabetes and cancer. It found that, despite public health efforts, obesity is on the rise in almost every country and in both adults and children. Prevalence has doubled in most countries over the past 30 years. Researchers also estimated that having a high BMI accounted for 4 million deaths globally, 40% of which occurred in people who were overweight but not yet obese. This demonstrates that being overweight may almost be as risky to health a...
Read more