As a therapist it is my job to provide help and advice to improve the condition of people who visit me. Osteopathy, being a holistic practice, should consider all aspects of a patient’s presentation when treating and advising. This includes the psychosocial aspects, which have a surprisingly large effect on pain levels as well as patient motivation and cooperation. 

Stress is rife. There is no other way to put it but I have yet to meet anyone over 18 in clinic who has no stress related manifestations in their complaint. Ironically our stress reactions are an evolutionary tool intended with assisting survival. Removing ourselves from a “painful” stimuli or preparing to defend our hard earned Pret A Manger vegan baguette from other hungry predators is the general idea of its purpose but other stimulii or stressors (like pressures from modern living, work, relationships and so on) are causing these reactions to remain active for longer than necessary at a variable rate. Now I could go on in to more detail on chronic stress the effects, but that will be for another time.

Clinically, stress can be a hindrance. The reasons being the enhanced pain levels resulting from the stress on top of the physical presentation. This then further increases the patient’s stress, further affecting work performance, sleep and other areas of life. It’s a spiral and not a very pretty one. This spiral can prevent patients from working with therapists, not just osteopaths, as they become tired, anxious and in some cases depressed – especially with long term chronic conditions. 

Now here’s the hard part: how can we encourage patients in a state of chronic stress to actively cooperate in maintaining the effects of treatment? In short you can’t force any one to do something they don’t wish to do but as a therapist it is important to listen to the patient, consider varied approaches and explain the benefits of cooperation for their current complaint. 

A good way to display this can be with feedback from other patients. I have had apologies from patients doubting me, which is beautiful but professionally may be beneficial in showing patients with a similar disposition towards treatment.

In some cases the pain itself isn’t the only stressor, as mentioned work performance can be affected increasing the stress reaction. This can be helped by discussion on desk posture changes and in some cases correspondence with the patient’s employer about aspects which are affecting the patient  (a doctor’s note if you will). This is merely an example but is proven to help reduce stress in patients, thus improving results in overall condition.

Taking pressure off of patients and offering professional support can make a huge difference in the effectiveness of treatments given and the cooperation of the patient. All treatments involve at least two participants. If one of these doesn’t take part in the process the other has to work twice as hard to get the desired results. 


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