Conversations About Pain: What Your Patients Need To Tell You

Conversations About Pain: What Your Patients Need To Tell You

A recent survey about pain management indicated that 67 percent of healthcare professionals would welcome patients arriving at their appointments with notes and questions. Unfortunately 48 percent of patients do not bring notes or questions to their appointments.  Learning to direct conversations about pain effectively will help you compile a clearer picture of your patients’ needs.

Allow them to Participate

Many healthcare professionals get so caught up in their own questionnaires they drive the conversation and do not allow their patients to participate effectively. Your patient may have come to see you with some goals in mind regarding their pain and what they are hoping to accomplish with treatment. Allow them to participate in the conversation by offering questions that direct them down this road so they can provide this information more easily. Consider asking questions such as “Is there anything specific you wish to accomplish through your treatment?” or “Do you have any concerns or questions regarding your last appointment?” This will let your patient know you want to work with them to overcome their specific challenges and meet their pain management goals. Encourage them to ask questions by stopping after you have explained something about their treatment. Watch for cues they seem anxious or confused and ask if everything is okay. As well try to avoid steering away from something they are telling you. It is easy to be so focused on your own questions that you redirect the conversation and miss important information your patient is trying to share.

Encourage Continued Care with Next Steps

You want to encourage a continuous care treatment plan with your patients and the best way to encourage them to continue with their care is to involve them with the decisions. After you review the treatment plan with your patient it is important to continue to provide input about next steps and the stages of care. Be certain that you encourage them to share information about their experiences following their last treatment and provide them some time to discuss improvements or set backs. By doing so they will feel more in control of their treatment and also feel you are validating their input. Following each appointment inform patients of what will take place at their next appointment. As well if a patient shared a concern with you at the beginning of the appointment explain that you applied less pressure or avoided the tender area and you would like to see if this makes a difference from the last appointment. Let them know how they can reach you if they have concerns. Keep pamphlets in your treatment room and provide them when appropriate. All of these steps will involve your patient in their own treatment and let them know you are listening to their needs and meeting them as best you can. Explaining why they may have pain following treatment as well as what to expect will set their mind’s at ease. This will keep them on track with treatment instead of getting discouraged and discontinuing care.

Recommend a Pain Journal

Pain in some cases can be intense yet fleeting. This means it is hard for patients to communicate effectively about pain and how it is affecting their day to day life. One of the best recommendations you can make to your patients is to keep a pain journal. Have them record intensity of pain, what they were doing when the pain occurred and how long it lasts. Also have them indicate how it affected them i.e. was able to carry on or was unable to move comfortably for the rest of the day. This will help you work together to pinpoint key issues and come up with a more comprehensive treatment plan to lead them to a pain-free life.

The Challenges of Treating Obese Patients

The Challenges of Treating Obese Patients

Obese patients have far more strain on their bodies than those of average weight. The more weight a patient carries the more health issues they will have including chronic pain throughout their bodies, particularly in the joints and back. As well, those who are morbidly obese tend to lead a sedentary life which can lead to serious issues including edema, high blood pressure and issues with mobility and range of motion. All of these issues make obese patients ideal candidates for massage therapy. Because of their size, obese patients can present some particularly difficult challenges made even more complicated when you factor in your own size. Being prepared to treat obese patients and meet their particular needs will allow you to treat patients of all sizes.

Understanding and Communication

One of the most important aspects of dealing with obese patients is to understand it may have taken a great deal of effort for them to seek help. Obese people often avoid medical treatments as they know that their weight is an obvious health issue they are not willing to discuss. This can pose problems for healthcare providers who will naturally be inclined to comment on a patient’s weight and offer obvious advice such as the need to lose weight in order to better manage many health conditions. When treating obese patients it is important to remember your role as an RMT and avoid discussing things out of your area of expertise including diet and exercise. Instead focus on making your office a welcoming place for your obese patients concentrating on making them feel better. Many RMT’s find it easiest to avoid mentioning weight at all and treating obese patients in the same way they do all of their patients as far as communication is concerned.

Body Size Needs

Larger weight requires special considerations from larger sheets to cover the body more comfortably to wider tables and chairs. You also have to consider the physical challenges obese patients face including manoeuvring in smaller rooms. When treating obese patients it is therefore important to keep your room as open and safe for them as possible. Make sure you always have larger sheets on hand to accommodate larger clients. A step stool is also advisable as it is harder for larger patients to get up on the massage table.  Be certain you do not make comments such as “I will have to get a larger sheet.” Make accommodations without announcing them to your patient.

Body Mechanics

You may find it difficult to access your patient as their size will mean their body will be higher off the table than the average sized patient. You will have to lower the table as much as possible in order to apply the massage effectively. Some RMT’s discuss with their obese patients about lying on the floor using a matt for a more effective massage. However this can prove a challenge if the patient is unable to get down on the floor, or worse get back up again. A good alternative is to treat patients by having them in the side position and you can then sit in a chair. This will allow you to use the proper body mechanics you need and may prove the most comfortable for your patient.  It will also be safer in some cases as many obese patients have difficult breathing when in the supine position.

It may be difficult to decide which modality is best suited to larger patients. Swiss massage applied with a light touch and strokes will help warm up the body as well as reduce your chance of self injury.