Yellow flags !!!

[emad]

Hi all:
Sometimes , over activity , work type ,work load and stress could create pain either back,shoulder or any area .

usually i ask the patient to decrease work load ........
S/he very fast reply i can NOT :cry:

when i fail to reach acceptable outcome , i reason using previous yellow flags.
this is not logic,beliveable ,social accepted :
Let us put ourselves in the paient posrion , if we have pain , are we going to stop work :?: :!:

I think we have to search other alternatives to treat pain while they are working , i think this is NOT a patient problem , it is our problem.
can we treat while they work.

cheers
emad :lol:

[nari]

emad

I agree, it is our problem to keep them going while they work. Taking time off work tends to produce the illness state in some, and prolongs pain, depending on the type of symptoms.

I would discuss what yellow flags you find, and look to change how they work (there are always some changes that can be made, or tried).


Nari

[Green Hornet]

People, who can't get off work, can't see the long term consequence. They sometimes don't have a choice -- need money, need to support family, worry about social and other's perception, get thretened of losing the job, etc. It could be a sciety's fault. We are living in a high-stress and high-demanding sciety. Sometimes, they just can't see it because there is too much going on with them.

We as a PT/health care professional have a hard time to change it. All we could do sometimes seems to be educating them, making best recommedations possible, and letting it go. If I start thinking that it is our fault, I would be burned out.

I would just do my best and let it go.

[BB]

That is always a difficult situation.

It is very tough to get these people better. Unfortunately, not only do the workers need education about the long-term, but their managers and bosses do as well. Many injured workers become angry becuase they really are getting questioned about faking, and are being pushed too hard because their superiors don't believe their pain.

I think to make a real difference for these people we really need to become more active with the employers....helping to develop light duty programs, educating about repetitive use injuries. Encourage them to refer their workers before they become the angry, over medicated, fearful of losing thier job people that we often meet.

Take a look at www.smartcarept.com It is a pretty comprehensive web site on industrial rehab.

My father is such a worker. He has had multiple surgeries and is in constant pain. Every time he hurts himself, he waits until it is too late or goes back too soon for fear of loss of pay. It is sad that people become trapped in their jobs that they can't afford to leave and their health and well being pays the price.

Cory

[emad]

Hi Cory , Nari& Takao:
thank you ,

It seems even that house wives (mothers) suffering that problem more than even workers , i meet a lot of mothers who perform certain tasks
which i feel like neural mobilisation of upper limbs nerves very long time , more forcefuly and daily , thus put ver high stress ,load on upper limbs and neck regions , so they come with a lot complaints ...

cheers
emad :lol:

[rolf]

Hi emad!
Most of the women her in Norway is "double working"and thats one of the reasons why our practise is more visited by women then men.
I have to educate them in the art of living..mentaly and physiclyto make them understand how to take care of their own body,its not my responsibility.I can gide them if want but at last its their choise,and they have to know, its not done over the night.,its a new way of living!Mentaly and physicly awarness heals but its alot of work,not an easy fix!
RIN

[emad]

Hi Rin & Bernard:

Yes , our societies put great stress over human beings , however i think the human being will be more productive if we gave him/her time of relaxation and rest in the form of interval rest , why not working the full time 8 hours into 4.5 hours + 4.5 hours and 3 hours of rest between , but the human beibg himself/herself will work more particularly private work which can not be controlled through laws/legisltions , only money the contoller.

cheers
emad :lol:

[Physiorob]

Hi

This is my first post!

I have read alot about yellow flags, and we must look at them when we assess out patients. There has been much work carried out and the best ones come from L Gifford and Chris Main. the best text is from the PPA handbook "Topical Issues in Pain 2 Biopsychosocial Assessment and Management. Relationships and Pains" which are a good easy read and I make all my students read them as they give a good backgrounfd to the Yellow flags.

[nari]

Yellow flags are crucial to determine, almost for every patient, whether chronic/persistent pain or not.
My question is:

At what point in your subjective assessment do you decide that a psychologist's opinion/assessment is needed?
Many physiotherapists are rather afraid of yellow flags; and would rather pass the patient on to a psychologist/social worker. the problem with that, at least here, is the extreme shortage of social workers and psychologists in the public system. So while they are waiting for an appointment with a S/W or psych, we need to see them and their psychosocial issues must be addressed before and during the times they see us.

Second question:

How confident are we, as a whole, to deal with psychosocial issues?
and for a new young graduate without life skills/experience yet, even more difficult.


Nari :roll:

[emad]

Hi :
Welcome the new memeber to the forum.
:D :wink:
Nari

You are right in your raised questions ,
during subjective assessment ,when we feel the patient need psychological support ,and assessment
i think this patient usually very clear .
i think two days ago ,one patient begin our subjective asses , saying i feel pain all my body , when i begain to assess palpation ,there were no pains , all our tests for back were negative ,i begain to speak to him more
his story ,he was in conflict with a women ,in which he is so ashamed culturally from all his relatives ,and people surrund him in a rural culture ,he stoped work and dealing with peoples ,begin to visit doctors ,take drugs for 7 months ,with more complications of drugs ....

this was so clear needs psycological treatment .

here there is no psychological management :evil:

Nari:

I think if we give great attention ,reflection using in dealings with psychological aspects in our managements ,with time we will be confident to address more successful this apect .
yes;all things for new graduates all is diifcult ,like me :wink:

cheers
emad

[rolf]

Hi nari!
In my early practise i thought that every painproblem had to be due to a physical overuse. Dualisme.As i grew older i saw that body and mind count be separated,and more and more scientific evidencs confermed this.
Ithink that you have to be confident in your self as a threapist but also as a human beeing,and have the importent understanding of the body-mind connection to deal with psychosocial issues.Your communication skills has to be good.
It isent easy to deal with a 50 years old patients personal problems when you are 22 and without lifeexperience.
Just some thoughts !(I like to read your answears on the different topics!I feel at mome!)
:wink: :wink: :wink:
RIN

[nari]

Physiorob

Welcome to the forum.

Re yellow flags - isn't it interesting to look at Gifford's list and realise that everyone of us would have quite few of them??

Nari :roll:

[flaviovitor]

Hello Somasimplers,

sorry for taking back to surface this thread again, but I don't know anymore how to UPLOAD a file anymore. Could you help me Bernard?

But, at least one thing I can show you in this old thread, entitled 'YELLOW FLAGS'. It there was no better place or thread to uploading the file attached by me in this thread.

But, I would like Bernard to transfer it to Sound of Silence, or teaches me how to go on with this.



Flávio.

[bernard]

Flavio,

You uploaded the file for sure. It is shwon as an attachment.
Are you experiencing problem with other type of files? Or does the board tell you that you reached the maximum allowed?

The Sound of Silence is a forum allowed to SomaSimplers and all SomaSimplers may normally post and upload files?

[bernard]

Flavio,

I moved the file for you.

http://www.somasimple.com/forums/showthread.php?t=1124

[flaviovitor]

Thanks Bernard,

I just don't know how to access the Sound of Silence and how to upload a file. It is not about anything else.

Regards,



Flávio.

[bernard]

I just don't know how to access the Sound of Silence and how to upload a file. It is not about anything else.

If you're able to access the link I provided in my previous post thus you acceded to The Sound of Silence. :D It is only the name of a private forum, reserved to SomaSimplers.

BTW, You reached it, clearly, since you posted a reply about Clinical Neurodynamics. ;)

The Sound of Silence works exactly as another forum but just visible by SomaSimplers. You can create a thread, make attachment...

The Sound of Silence (http://www.somasimple.com/forums/forumdisplay.php?f=20)

[flaviovitor]

Ok Bernard,

great, beautifull!


Flávio.