Are you recovering from an acute injury or managing a chronic condition? What are your thoughts and beliefs about your ability to improve? Are you afraid to move because you're fearful that it'll be painful? Or do you think that surgery is the only solution to your problem? Often, one of the most overlooked factors in one's recovery is the role of attitudes and beliefs.
Research has shown that pain does not relate directly to tissue damage. How many times have you gotten a bruise without remembering where it came from? (There is tissue damage but no pain.) What about stubbing your toe on a piece of furniture? (There is no tissue damage but a tremendous amount of pain.) Pain is not just a message sent from injured tissues; it's a complex psychological dimension that is influenced by our past experiences, our thoughts, our beliefs, our attitudes, and so much more.
Beliefs about pain and the desire to avoid pain can cause us to avoid certain activities. After an injury or illness, people tend to feel that participating in physical activity or doing daily activities will make their condition worse. This phenomenon is referred to as "fear-avoidance beliefs." The fear of pain or the desire to avoid pain then becomes a major limitation in a person's willingness to remain active and get better. It's important to remember that physical activity is beneficial for you. It's been shown to improve health outcomes, physical abilities, and general wellbeing for people with a variety of different health conditions. Now, this doesn't mean that you should go all out and start training for the Olympics... just start off with something easy and gradually progress. It would be wise to get advice from a physiotherapist who can design an appropriate program for you and monitor your progress over time.
The power of words is also very important. An elderly patient of mine told me that his doctor told him that it's normal for him to start having aches and pains because he's 80 years old -- "what do you expect at this age?" he said, "just put some cream on it." We, as healthcare practitioners, need to be careful about what we say to patients and how we say it. Patients tend to overreact to words like "arthritis," or "degeneration," or "disc bulges," or "(insert scary medical term here)." Most doctors aren't very helpful either when they tell patients their medical imaging results without really any explanation. Imaging tests are important diagnostic tools to rule out serious medical conditions; however, once any serious problems have been ruled out, the findings provide little to no value to explain your pain. Studies show that medical imaging may even be harmful from a psychological and emotional point of view.
I had a new patient last week who's had chronic low back pain for 12 years. She's tried everything except physiotherapy (because she heard that "physio makes you worse"), and she told me that she just wants surgery. I inquired as to why she came to the clinic for physiotherapy, and she said that it was because nobody would operate on her unless she's tried absolutely everything (including physio). She's had a failed surgery in the past (on her elbow), and she still thinks that surgery is the solution to her problem "because she has two herniated discs." She told me like it's self-explanatory, as if the words "herniated discs" automatically warrant surgery. I explained to her that if the only reason why she's at physio is to get through the "last stage" before surgery, and that if she doesn't believe in physio or think that it'll work, then it's most likely not going to help her. Nevertheless, I made her promise to try it for at least 6 to 8 weeks to see what happens.
What you think about your current condition, your ability to manage it, and the likelihood of recovery matters. Sometimes, you just need to change your thoughts in order to improve your health and wellbeing. It's also important to develop a healthy and trustworthy relationship with your healthcare provider. An effective therapeutic relationship can help you gain the education and reassurance you need on your road to recovery.
