Approaching patients who have possible neurological problems, as well as other complex cases such as chronic pain, with the mindset of a detective, in particular Sherlock Holmes, means that observation and deduction are consistent skills used to derive a meaning from the presentation. The ability to pick out subtle clues via the observation of movement, the way in which the body is postured, the language used and the accompanying gestures will all provide clues, building a picture that is enriched by the narrative, the story that the patient tells.
We must listen in detail to the patient, guide them in telling their tale, that often begins at a point in time that is earlier than would otherwise be thought relevant. How was this person primed by an illness or injury that subsequently manifested in the current condition? How did this problem evolve and what have been the influences?
Only through this detail can we start to understand the nature of the pain or problem, illustrated by changes in movement and function that must be observed with full concentration so as not to miss the most gentle of altered patterns of motion. A mindful approach to detective-based assessment is one way in which this can be achieved.
There is much that can be drawn from great detective work and as elucidators of the body’s responses to pathogen and disease, we can apply the skills with instinct, knowledge and compassion to then become the architects of conditions that allow for change.
RS: Specialist Pain Physio Clinics — the contemporary approach to painful problems 07932 689081