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As a Physiotherapist, I take details of my patients’ symptoms and medical history. This takes about minutes on average, depending on the nature of injury and depth of medical history.
This is straight forward enough – the patient tells me the story of what has happened and I ask detailed questions to find out more about what has happened, what they are experiencing at present and what other medical conditions they currently have or have had in the past. Each and every one of these questions serves the purpose of enabling me to investigate which structures are injured and what is causing these structures to be injured so that I can create a treatment plan or, when necessary, refer them on for further scans and investigations.
Most patients engage well with this part of the process but sometimes the questions relating to other medical conditions, past or present, can seem a bit obscure and people don’t understand why they are being asked them so there can be a resistance to answering them, perhaps thinking that I am being unnecessarily curious and/or using up precious treatment time.
I therefore need to explain to the patient that there can be that can be a connection between their current painful symptoms and underlying medical conditions. However, there is not enough time to explain the reason for me asking each question and it wouldn’t be appropriate because it would create unnecessary anxiety. For example, ‘I am asking this question because it can help me establish whether your pain is being caused by a cancerous tumour’ would not be a sensitive or sensible way of handling these situations! I therefore have to reply on a patient trusting my explanation that ‘I know they seem strange but please do trust me that each and every one of my questions serve an important purpose. As I ask these questions I’m building a picture in my mind of what the underlying cause of the presenting symptoms could be.’
By acting as a detective in this way I can work out if the patient’s symptoms that are manifesting in the muscles, bones, tendons and joints could be being caused not by the mechanics of the musculoskeletal system but other things like medications, blood conditions, cancer, heart problems, thyroid problems and diabetes, to name a few. Sometimes these causes are life threatening if they are not picked up quickly and therefore the seemingly obscure questions may in fact be lifesavers.
For example, I once had a patient who thought they had a calf strain but actually had a DVT and had to be admitted to hospital immediately for life saving treatment and another patient who’s pain was being caused by severe osteoporosis as a result of the side effects from their medication and was at risk of immediate hip fracture. They had to be given enforced rest at home with ongoing investigations.
So, if you are seeing a Physiotherapist or other health professional, my advice is to be as open as possible, even if you think medical conditions could not be linked make sure you share them when asked and allow your personal detective to build a thorough picture. You never know if it’s your life that may be saved.
Please get in touch with any comments and check out my bio on this website for more information on my experience and specialisms. To book now email firstname.lastname@example.org or call 02075838288.
… and please don’t forget to share with friends and colleagues.
Alan Barbero BSc (Hons) Physiotherapy, Dip Sports Therapy MCSP
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