This recent study (Zadro et al 2021) demonstrated that the way shoulder pain is described and diagnosed can influence the individuals’ perceived need for imaging and surgery. Patients told that their symptoms may be related to a rotator cuff tear were more likely to perceive the need for further imaging and surgery than patients who were assigned a label of bursitis or subacromial impingement syndrome.
I would even go as far as saying even that also the terms impingement or bursitis needlessly add to the perception of damage, inflammation, and structural defect that requires protection and cautiousness to not irritate. The excess amount of fear avoidance beliefs over several months can of course lead to greater pain and disability.
For many of my patients, the word that I have now adopted when providing a diagnosis is “sensitivity”. I may be wrong, but I have thus far experienced that patients appear to be okay with the term “sensitivity” as it is the least threatening of many other potential diagnoses.
I now diagnose my patients as having plantar heel sensitivity or patella-femoral Sensitivity or lumbar flexion sensitivity or neck extension sensitivity etc. Why? First of all, patients are less inclined to catastrophize the term sensitivity. Secondly, the term implies that the treatment of a sensitive condition is to “desensitize” it.
How does one desensitize a sensitive part of the body?
- Reduce fear of the condition
- Modify activities that may be contributing to the sensitivity
- Graded intentional exposure to the activities and movements that are perceived as threatening, but performed within a SAFE context
Does that not summarize the 3 things that we must all focus on as physiotherapists?