The “context” in relation to your pain is the combination of factors contributing to your personal pain experience at a point in time.
Your “context” is made up of multiple factors such as:
- Physical factors (muscle tension, strength and physical capacity)
- Psychological factors (beliefs, protection or avoidance)
- Social factors (support, work or life stress)
- Lifestyle factors (lack of sleep or exercise)
- Health co-morbidities (obesity, mental health).
The relevance of these factors will vary significantly between people .
A key contributing factor to your “context” are your beliefs related to your pain. Health care professionals have the largest influence on this and can have a positive or negative effect.
This is really important because evidence suggests the explanations health care professionals provide are still primarily related to structural “damage” or “disease” on scans or imaging. This is despite evidence that only a few of these findings are relevant – and only to a small group of people (8-15%). For 90%, they have a poor relationship to pain or outcomes.
These explanations often lead to protective strategies, worry and concentration on your pain. When these strategies fail to work for you, it often feeds a cycle of frustration and worry, less control over your pain and less physical activity creating an unhelpful pain “context”.
If you were in pain, couldn’t make sense of it and got told your “joints are degenerating and wearing out, you better be careful…”. Who could blame you? It’s not patients who are to blame, it’s the healthcare professionals!
There is good news!
Getting appropriate, evidence informed information, an explanation making sense of your situation and a plan for you to gain control of it can help you break the pain cycle or stop one kicking off. This can reduce your worry and “threat”, promote positive behaviours and more physical activity allowing you to do the things you value.
The reality is the best person to explain your situation and what your feeling is you!
As health care professionals we need to give you time, listen and help you make sense of what your thinking and feeling (your “context”). We need to work with you to teach you to control your pain and gradually get you back doing the things you enjoy. This is what you can expect at Quest Specialist Physiotherapy.
A recent study explores how contextual factors affect physiotherapy outcomes. You can read this study here: Contextual Factors and Physio Outcomes Testa & Rossettini (2016)