Your ultimate guide to clinical reasoning part 3 - Subjective assessment & unpacking patient answers with Mark Jones

When your patient is anxious, depressed or unable to work, how will you assess and manage the psychosocial aspect contributing to your patients pain? When should you refer on to another health practitioner, like a psychologist?

Social factors like our patients employment, relationships at work, home and with friends all influence our patients pain experience. How do we address each of these social elements in a biopsychosocial approach to our patients pain?

In Your ultimate guide to clinical reasoning part 3 - Subjective assessment & unpacking patient answers with Mark Jones, you will discover:

• What social factors influence your patients pain?
• What can Physios actually do about social factors affecting pain?
• Types of flags for screening - including red, orange, yellow, blue, and black
• Screening psychosocial factors with our patient interview, multidimensional screening questionnaires and unidimensional assessment questionnaires
• How to unpack your patient’s beliefs and feelings to identify their personal perspective
• Important areas & questions you need to include in your subjective assessment
• How questionnaires improve your patient assessment
• How to use your patient interview to choose relevant questionnaires
• How to use questionnaires in your assessment to help identify neuropathic pain, central sensitisation, and psychosocial issues
• What are the limitations of commonly used questionnaires, and how can you overcome these limitations?
• Which questionnaires identify psychological distress
• How to use the patient interview to select your questionnaire
• If your patient is anxious, fearful, angry, depressed, catastrophising, off work or has widespread pain, alodynia and hyperalgesia, which questionnaire should you use?
• How can you incorporate pain neuroscience education into your treatment?
• How can you manage psychosocial issues contributing to your patients pain?
• When do you need to refer your patients on to another health practitioner eg psychologist?

In part 1 you explored how to quickly recognise diagnostic patterns, and confirm our diagnoses and treatment decisions with “slow” analytical clinical reasoning to get the best results for our patients.

Part 2 helps you identify psychosocial factors, patient perspectives and maladaptive thoughts, beliefs and emotions that affect outcomes and play a role in your clinical reasoning.

In Part 4 you will explore types of pain your patients experience, including neuropathic, nociceptive and nociplastic (maladaptive CNS sensitisation). You will discover how to use clinical patterns and tests in cervical spine neuropathic pain patients, demonstrated in a case study, plus how to identify strength, ROM, motor control and neurodynamic impairments related to your patients pain.

Part 5 covers precautions and contraindications to assessment and treatment, red flags you need to identify, when to get your patient immediate medical attention, and a case study example of red flags masquerading as shoulder pain. You will explore how to put all of the information you have gained together with clinical reasoning to develop a treatment plan.