Nocebo and the Power of Words

Words Will Never Hurt Me... Or Will They? Words matter. It’s amazing how often patients share stories about how other providers have explained their condition in horrific terms. “Your arthritis is terrible” or “your back is a mess.”The “placebo” effect is well-known, but its counterpart, the “nocebo” effect is just as strong (if not stronger), [...]

The 5 A’s for Behavior Change and Weight Loss

We Need to Change If you have ever quit smoking or lost a lot of weight, then you know how hard it is to change your life. You wouldn't be alone in feeling that your doctors didn't care about your struggle... or perhaps even judged you. The healthcare industry is clearly having a difficult time with overweight and obesity [...]

Cognitive Behavioral Therapy for Fibromyalgia

Going Mental With Fibromyalgia Do you ever feel like a psychologist in the clinic? Pain affects so many aspects of life, and some days I am navigating emotions, thoughts, and behaviors much more than I am assessing joint mobility or muscular function. Fibromyalgia is one condition that can be overwhelming at evaluation because the patient might say [...]

Treating Fibromyalgia With Exercise

Everybody Get Up: Treating Fibromyalgia Two weeks ago we covered the diagnostic criteria and some of the pathobiology of fibromyalgia. All of that isn’t so helpful without strategies for treating fibromyalgia or widespread pain in general. This week and next week will focus on evidence for treating fibromyalgia. Oh, and what happened to last week's [...]

Is Positive Behavior Change a White Whale?

Behavior Change: Fact or Fiction? Physical therapy practitioners promote behavior change.We ask patients to exercise more; we educate patients about the type of activities to do (or to avoid). We might even talk about diet, weight loss, smoking, stress, and sleep.  I feel that patients care way less about the anatomy & physiology and instead [...]

How Should We Treat Hip and Knee Osteoarthritis?

Osteoarthritis: The Gateway Problem? Osteoarthritis is one of the most common points of entry to the physio clinic. I feel that it’s a “gateway” condition -- once people find out that they have arthritis, sometimes they talk as if it’s only downhill, as if their pain and functioning will only get worse. But “getting worse” is [...]