Why keep treating?

Seldom do I pick up and read a qualitative study, however this one caught my eye (survey followed by a qualitative analysis). I was disturbed by a few things in this article. First, the term “physical therapy clinicians” was used to refer to PTs, chiropractors and osteopaths. Secondly, why is anyone continuing to treat patients with LBP for more than 8 visits or 3 months who have shown no improvement?

Josh

Download persistent_back_pain_keep_treating_EuroJPain_2006.pdf

Comments

[Mark Armstrong]

It seems that the manual providers in this study saw their role as support--let the patient dictate the treatment with a fear of the conflict associated with discharging the patient. Their mantra would be "Support it and never move on". I admit it is difficult at times telling some patients we are maxed out with care, any thought on ways to move patients out and on?

[Phil Schaible]

JOsh, the age old question, when is therapy not effective or going to be? I have certainly occasionally kept a patient beyond this time frame, generally when from their past history I know that this is the last option for them, and if we make no progress then they will likely live with their condition. More improtantly than the 8 visits for me is what was done those 8 visits, and given the lack of progress had appropriate reassessment been done, the treatment changed and had a referral to another therapist with a different approach been considered? phil