It has been said that odds of success or failure in helping a patient with most forms of treatment center around whether or not the patient “believes” that the proposed treatment approach will help. In other words, “…the power of positive thinking” and how it enters into the care and management of patients is an important part of treatment success (or the lack thereof).
Looking at this question strictly from a scientific, evidence-based view point, it has been and continues to be difficult to quantitatively “measure” the outcomes achieved from treatment administered to the negative-attitude vs. positive-attitude patient. For example, studies of cancer patients show improved outcomes for those who participated in group therapies by way of improved quality of life, a lower risk of developing depression, and reduce tension, anxiety, and fatigue. However, the group therapy sessions did NOT result in increased longevity. In this case, those with a positive attitude had a higher quality of life and happiness, were more productive, and were less of a burden for those around them during the remaining time left in life, which was of great value!
What about attitude in the management of back pain? The model recommended for those of us providing care for patients with low back pain, neck pain, and other neuromusculoskeletal conditions is called the “Biopsychosocial model” (BPS). Though the concept was originally discussed in the 1970s, it is was first recommended and embraced as “the model” to follow in the late 1980s (as opposed to looking at back and neck pain strictly from a “biological” viewpoint). In a recent article, looking back over the last 25 years since the BPS model was formally introduced, researchers found “good evidence” for the role of biological, psychological, and social factors in determining the cause as well as the prognosis for back pain. Embracing this model has stimulated research into the investigation of these three factors and has allowed us to better understand prognostic factors that can lead to an increased likelihood of a prolonged or poor recovery. For example, depression, anxiety, poor self-control of a condition, and self-limiting beliefs about future ability to work or physical activity are psychosocial factors studies have associated with poor outcomes.
The most important factor about attitude and how it relates to the care you receive is that both you and your doctor share in the common goal of achieving improvement and hopefully full resolution, regardless of your complaint. Know that when you first meet with your doctor of chiropractic, he or she will conduct a thorough history and examination and then sit down and discuss your treatment options including, but not limited to, chiropractic care. Chiropractors are trained to consider the whole person and NOT to segregate your back, neck, or extremity complaint(s) from the rest of you, including the psychosocial aspects. How your back pain and/or other complaints affect you emotionally as well as physically are both very important! When pain becomes chronic, helping you learn how to control the condition rather than allowing the condition to control you is a common goal shared by both doctor and patient.
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