Mental Health, Chronic Pain, and Physiotherapy

Caitlin MilljourArticles & News

I had the opportunity to attend the Manitoba Physiotherapy Association Annual General Meeting (say that 5 times fast) this weekend. I connected with a colleague and we were discussing our craving for having deeper and more meaningful conversations with our patients. We wanted to say more than ‘How about that weather?’, ‘Aren’t you excited to see the snow melt?!’, or talking about how traffic was today. It got me thinking about how there is a tremendous lack of discussion about mindset with our physiotherapy patients.

There has been a large amount of research that confirms there is an undeniable link with mental and physical health. ‘People living with a serious mental illness are at higher risk of experiencing a wide range of chronic physical conditions. Conversely, people living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population’.

Now, I experience chronic physical pain on a daily basis. Breaking both of my ankles, having multiple surgeries, and learning how to walk again at the age of 21 put me on a fast track for the majority of my 20s to experience borderline depression, anxiety, emotional stress…call me a textbook patient of how chronic pain affected my mental health. Am I more empathetically in tune with my patients because of what I experience on a regular basis, or am I simply craving a more meaningful experience for my patients that I treat?

I don’t think you need to have your life turned upside down to know how pain can affect your day to day life. Physiotherapists need to channel that experience and drive it into all patient interactions. Instead of asking: “What are your goals?” or “What makes it worse?”, perhaps ask “how does your issue affect your day to day life?”, “What are you guarded about doing?”, or “What are you no longer able to do that is important in your day to day life?”

‘Mental and physical illnesses also share many symptoms, such as food cravings and decreased energy levels’. The first thing I think about the decreased energy levels is decreased compliance with their therapeutic home exercise program! It is our job as physiotherapists to ensure we take the time to really dig deep and figure out a solution to overcome their personal barriers for lack of compliance and setbacks.

I’m curious to know what my fellow health care professionals have experienced with similar circumstances. Do you think mental health and mindset is taking a big enough forefront to give our patients the best possible care? Let’s start a conversation!