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The Behaviour Of Patients With Whiplash Pain

We have covered attitudes and beliefs towards pain and now we can consider the way people with pain actually behave.

How people behave with their pain may tell you more about what they are really thinking than what they tell you at the time you first see them. You can keep your nose sensitive for behaviours which could be unhelpful.

Behaviours thought to be unhelpful are:

  • Using extended rest time to treat the pain.
    Resting to help pain makes sense to us intuitively. At least it does at the beginning. Pain means damage after all, doesn’t it? Unfortunately this does not make a good strategy for the longer term.

    If you rest a lot for your neck pain and hope this will help, you may be disappointed. It’s a danger sign from our point of view. Resting makes us unfit, reduces our confidence and is boring and depressing in the long term. The body is designed to be used and responds badly to extended periods of strongly reduced activity.

  • Having a reduced activity level and withdrawal from normal activities is also a danger sign. If you have stopped doing most of the things you used to, have stopped going out socially and are beginning to feel anxious about being in crowded places, then you are more likely to have a longer term, disabling problem.

  • A very high reported pain level is a risk factor also. We often ask patients to rate their pain on a 0-10 scale, with 0 being no pain and 10 the worst pain they can imagine. If someone reports their pain is 10, or off the scale at 11 or 12, this indicates distress and makes it more likely there will be a longer term problem.

    Cited Reference:
    Moore A, Jackson A, Hammersley S, Hill J, Mercer C, Smith C, Thompson J, Woby S, Hudson A (2005). Clinical guidelines for the physiotherapy management of Whiplash Associated Disorder. Chartered Society of Physiotherapy. London.



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