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May 2, 2008

Pain Scale

Yesterday, I talked about range of motion with regard to joint architecture and circumstances. One circumstance for conservative approaches to range of motion involves client pain. With any therapy that is being "done to" a client, it is always crucial to establish good communication. Part of that communication should help to develop rapport and trust. The other is to convey information and demonstrate good common sense when administering a modality.

With my clients, if I'm working with a condition that is painful, I like to establish what I call a pain scale. If I know therapy is uncomfortable, I warn them that it may not be pleasant. I also explain my rationale why we have to do the therapy and what it should accomplish. I explain the pain scale as follows: "Let me know if this hurts you. For example, on a scale from one to ten, one is no pain, ten is unbearable. I don't want your discomfort over a five, which is the therapeutic level."

We proceed with the modality, and sometimes, people say five right away out of fear of anticipating pain. It is imperative at this point to stop or back off and "check in" again to see if they are okay. This helps build trust. If your client is expecting therapy and not straight up relaxation, they should relax knowing that they truly are in control. Therapy should go a little easier after that. If the client cannot relax or continues to exhibit pain beyond what would be expected for a given condition, it would probably be a good idea to refer out to another professional. Better safe that sorry--better not to inflict undue pain--it could be something beyond your scope of practice.

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Posted by linda at May 2, 2008 8:40 AM

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