Is the McKenzie Method any good?

McKenzie: You're all I ever needed /So tell me what to do now? What do you think about the McKenzie method? Also known as Mechanical Diagnosis and Therapy, the McKenzie method is popular and influential. But is it any good? This issue of Physio Weekly addresses some recent research findings on spinal pain, with some interesting [...]

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), [...]

Risk and Resilience in Pain

Resilience Despite Pain Wellness is bigger than the absence of illness. One of my problems with the healthcare industry is that the predominance of the biomedical model leads us to treat pathology rather than actually promoting and reinforcing health. I mean, do we even deserve the term “healthcare” anymore? Here’s where it gets worse: Under a [...]

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 [...]

What Is Fibromyalgia?

Fibromyalgia: The F Word When I was a student it was interesting to see how other therapists would treat widespread pain.A clinical instructor of one of my classmates said you can't really expect anyone with fibromyalgia to get better. Another therapist said that whenever we see someone who says that they have fibromyalgia, then we [...]

Lateral Hip Pain and My Trigger Word

"It's Just the Bursitis." Or is it? Do you have trigger words in the clinic? I know I do. One of mine is “bursitis.”I get a little miffed because I anticipate determining that it's not just bursitis (if at all), which makes for an interesting discussion with the patient. The hip is tough to evaluate, [...]

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 [...]