Injury Management. Are we doing enough?
As a Chartered Physiotherapists, we see and treat people in pain. We see people from all walks of life, from elite level athletes to older person struggling to get out of a chair. We assess, treat, and progress their rehab to assist them with the goals they want to achieve. Whether that be, competing at the highest level in their sport or trying to walk independently without the use of walking aids.
One of the most common patient presenting for physiotherapy assessment is, a long history (over 3 months) of their symptoms, managed solely with medication and rest. Unfortunately, for many injuries, this isn’t going to get you better. It is our duty as medical professionals to give you the most up to date evidence to assist you with improving your symptoms and getting you back to your normal for the long term. One of the most important factors in getting you back to your normal quickly, is quick access to physiotherapy services. We are here to assess, diagnose and manage your symptoms from initial injury to return to activity. Waiting for 3-6 months to see if an injury settles itself is an ineffective use of time and many studies have highlighted the benefits of early intervention for early return to activity.
It is worth mentioning controlling pain and helping you achieve your goals by getting you back to your best are two very different things which are often confused by many people, including medical professionals. Controlling pain with medication and rest can help alleviate your pain, however, it can give you a false impression you are back to normal. As a result, we return to sport/activity only to find a return of your symptoms.
A far better option is to control your pain, ease off aggravating activities, seek physiotherapy assessment, advice and guidance, commencing rehab, gradually progressing exercises and return to graded activity to get you back to normal safely and effectively.
We have provided 2 real life case studies to highlight the need for early physiotherapy intervention and management rather than opting for medication and rest:
Case study 1:
A 55-year-old male complains of shoulder whilst working in the garden 2 months ago. They present to their GP who advises rest and pain medication and advised to take these for the next month. A month later to return to their GP explaining the medication helped, but they finished their course and the pain returned. The GP increases their pain medication and advised to continue for another month. The following month the patient returned as previous with no resolution in their symptoms. The were sent for xray and more medication. The xray comes back with mild osteoarthritis and no change in symptoms. They were then sent for an MRI. The MRI report highlights mild degeneration of the rotator cuff muscles in the shoulder and was referred for orthopaedic opinion. The surgeon reviews the patient and MRI and highlights surgery isn’t necessary and to complete a course of physiotherapy management. Following physiotherapy management and advice the patient sees an improvement in their symptoms over the following 3 months and reports approximately 80% resolution in their symptoms. From initial injury to 80% improvement in their symptoms, the total time taken was 10 months.
Case study 2
A 40-year-old woman presented to her GP with increased shoulder pain after lifting a box at work 2 weeks ago. The GP advises physiotherapy and medication to help control her pain. The patient commences physiotherapy management and the physiotherapist highlights further investigations are not warranted at this time. She completes a course of physiotherapist led rehab over 3 months and sees over 75% improvement in her symptoms. From initial injury to 75% improvement in their symptoms, the total time taken was 5 months.
There are obvious cases where physiotherapy management isn’t effective, and onward referral is necessary, or further investigations are warranted, immediately. We can assess and help guide you with the most appropriate management. We are here to help you and guide you not only back to full health as quickly and as safely as possible but also to get long term relief by continuing with rehab long after your symptoms have settled.
Early intervention is the clear winner in this instance. Don’t suffer with pain, don’t ignore it and hope it gets better with just medication alone. Help yourself by opting to get a detailed assessment by a specialist physiotherapist to help you get better quicker and back to doing the things you love to do.