Generally speaking, most initial healthcare visits include history taking, a physical examination and treatment. Interestingly, both patients and health care providers (of all disciplines) tend to attribute reduction in primary complaints to the treatment provided. However, little thought is given to the influence history taking and/or the physical examination have on the outcomes.
More recently, there has been a shift toward the biopsychosocial model, including increased attention on the therapeutic alliance (TA), which is defined as the working rapport or positive social connection between the patient and the clinician. This includes a complex blend of the clinician’s technical skills, verbal and non-verbal communication, sense of warmth, collaboration, and trust. This, importantly (and logically?) has been shown to have a powerful effect on pain and outcomes. Strategies such as active listening, being present in the moment, acknowledging the patient’s individual experience, eye contact, empathy, etc. employed during history taking have all been shown to help build trust and foster the TA. As well, the physicality of touch during the examination may further build that trust and TA.
This study investigated if the ritual of the examination might result in a meaningful change in pain and function for patients presenting with LBP, before implementing any treatment interventions. Specifically, the study aimed to test any therapeutic effects of the history taking and physical examination…LOG IN OR SUBSCRIBE TO ACCESS THIS REVIEW!
THIS WEEK'S RESEARCH REVIEW: “Evaluation as a Component of Treatment for Low Back Pain”
This paper was published in the Journal of Manual & Manipulative Therapy (2020) and this Review is posted in Recent Reviews, Low Back Pain, Clinical Testing & Procedures and the 2020 Archive.
Evaluation as LBP treatment