Should I find a new physiotherapist?
July 29, 2016 6:38 PM   Subscribe

I'm seeing a physiotherapist as part of a treatment plan for chronic pain. Recent events have made me wonder whether I should try and find a new practitioner. But maybe I'm overreacting?

Physio is part of a treatment plan to help with chronic jaw pain. Until recently things had been progressing well (I thought) but I've run in to some issues, and I'd like to know if I've reading too much into the situation.

It became clear in the most recent session that the physiotherapist was under the impression I was completing a certain exercise which require a foam roller as part of at-home workout. I was not, and further did not even own a foam roller. I do not remember at any time being told explicitly to include this exercise as part of the regime. Said exercise was first demonstrated a few weeks ago, so I've missed out on more than a few of these. Maybe there was some implicit expectation that any demonstrated exercise should be included, but I'm sure no detailed instructions were given about how to do it at home i.e how many times to repeat it per side and so on.

I was told at my last session, essentially, "When I saw you walk out of here last time, it looked like the session had not even happened. You can keep coming here forever, but unless it improves outside of the office, no progress will be made." I understand that is important to be honest about treatment, but this kind of dialogue makes me want to throw up my hands and walk away. If it's all useless, why am I wasting time and money coming here? I honestly thought I was doing what was required of me.

And to add to the irritation, Physiotherapist cannot get my name right. That is, they refer to me by my family name and not my given name. I've talked about this but it keeps happening. I try not to fixate, but it's annoying.

I also finding it difficult to tell whether the physio is 'working' in any sense. My pain is better, but the treatment plan includes nerve blocks, better sleep, etc. so I'm not sure what the efficacy here is.

Mentally, I just keep running and circles and my worry is not helping me feel better. Should I find someone else? Am I overreacting? Are there other steps I should take? I hate my pain and I want to get better, so my usual strategy of just giving up on everything won't fly here.
posted by Gin and Comics to Health & Fitness (6 answers total) 1 user marked this as a favorite
Ditch them. Can't get your name right and have not read/taken adequate notes after each session? They're inadequate. Ask your doctor/dentist for a recommendation for another one.... and give precise, but polite, feedback as to why you're leaving. You actually sound like a perfect patient (without knowing if your expectations are reasonable for your condition.)

But this physio leaves themselves right open to litigation /misadventure if they're not doing detailed notes each session and revising them. Dtmfp.
posted by taff at 6:54 PM on July 29, 2016 [3 favorites]

Physio is hard enough without feeling like you're not being heard. If you have other reasonable options you should take them, but you'll need to weigh price/distance/trouble getting comfortable with a new person etc against sticking it out with your regular people and perhaps having a confrontation.

I know that sometimes people respond well to the tough love approach, and sometimes it's the only thing that works to get people to actually do their exercises at home, but have you ever indicated in any way to them that you're that kind of person?

This kind of communication issue can only be fixed if you can take the initiative to talk to them about it. If you can do that, then there will either be a resolution and you can stick with them and the expectations and communication will hopefully be clearer, or they will continue to not listen to you, in which case it's definitely time to pack it in and find another physiotherapist. You can also just shop around for someone else, but you'll never know if this could be resolved if they're unaware that there's a problem in the first place. It's up to you what your priorities are in this case, but I think your concerns are valid and worth making an effort to change.
posted by Mizu at 6:55 PM on July 29, 2016 [1 favorite]

While it's super important to do the physio regimen at home, it's equally important that the regimen be clear!

A good physio will:
- use the name you ask them to use
- work with you to ease the symptoms of acute pain
- work with you to ease the chronic issue
- give you detailed notes (including illustrations, if needed!) for each exercise that's part of the at-home regimen
- let you know the frequency of the regimen
- schedule follow-up appointments at regular intervals (generally more in the early stages, then more occasionally)

And those are just the basics, IMHO, for a decent, worth-the-money session. A GREAT physical therapist will also talk to you about what's going on in your life, will remember the details about you, will adjust things without your even asking (after asking once)...

Ditch this physio. Go elsewhere. Be sure to communicate your preferences to the new physio (notes on exercises, frequency, etc). Keep up treatment and ensure you're doing your at-home work as well.

Good luck -- a good physical therapist can do wonders!
posted by juliebug at 7:19 PM on July 29, 2016 [4 favorites]

You're not overreacting! It sounds like you're a conscientious patient who's trying to do everything they can, and that it's not your fault this isn't being communicated clearly to you.

Like Mizu said, it might be worth trying to bring up the issue before you leave. I almost quit seeing a physiotherapist once because she was disorganized and unclear -- but she also knew her stuff, I'm glad I stuck it out, because she got me better. I had to make a point of asking her to clarify exercises and "homework" at the end of every session, though.

As a patient, it's hard to know whether it's helping because you're the one with the problem, not the one with the expertise, and that can be frustrating -- but if you have any doubts about your physiotherapist, or if you are constantly feeling belittled, confused, and like you cannot communicate effectively with them, get a new one. Physiotherapy is expensive, and with chronic pain, it's important to get good treatment as soon as you can, instead of fumbling around with a treatment plan that isn't working while the pain gets worse. Best of luck!
posted by stellarc at 7:32 PM on July 29, 2016

There are so many physiotherapists out there. Find one you like. Dump this one.
posted by crazycanuck at 7:43 PM on July 29, 2016

You are not overreacting. This sounds essentially like you're being treated like a number, rather than as a unique individual. Find a new practitioner.
posted by vignettist at 8:17 PM on July 29, 2016

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