Physiotherapy Pain Association study day: Physios should ‘get out there’ to drive a change in practice

A senior physiotherapist has called for a revolution in the management of pain, saying that change isn’t happening fast enough.


Senior physio and cognitive behavioural therapist Zara Hansen

Physiotherapist and cognitive behavioural therapist Zara Hansen said it was vital to persuade colleagues to ‘walk the walk’ as well as ‘talk the talk’ in embracing a biopsychosocial approach that focuses on people’s mental, emotional and social needs when dealing with pain.

Speaking at the Physiotherapy Pain Association study day and AGM in Edinburgh on 20 January, Dr Hansen said it was important to get the message out there rather than simply gathering with like-minded people in person or on social media and ‘patting ourselves on the back’.

Dr Hansen said that although the biopsychosocial model had been around in some form since the 1950s, wholehearted and effective take-up had been slow, with some physios mistakenly thinking they are putting it into practice. ‘They say “I’m doing manipulation and a little chat and heigh-ho we’re fine”,’ she says. ‘It feels like it’s become just another tool in the physiotherapy tool box.’

Dr Hansen, a post-doctoral research assistant at the University of Oxford, said she was cautious about recommending seeing a physiotherapist if family or friends had mild to moderate pain because she’s worried about iatrogenic harm. ‘As a physio, that really bothers me,’ she says. ‘And I know there are brilliant physios in every department.’

Dr Hansen said it wasn’t easy to change behaviours – either in patients, or in physiotherapists – and that not everyone adheres to clinical practice guidelines.

Key strategies for achieving change include educational materials, interactive educational meetings, clinical audit, reminder systems and recruiting opinion leaders to spread the word.

'Health professionals listen to other health professions, peer to peer,’ she added. ‘So my call to arms is that we should be realising this and utilising it.

‘What we really need to do is get out there.’

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