44
Understanding and Implementing Trauma-Informed Care for Clients in Pain: Summary
CASE STUDY 3: JANE AND JILL
Jane and Jill are two women of the same age who come into your physical therapy clinic and present with the same musculoskeletal diagnosis that has plagued them for 5 years. The mechanism of injury was the same, and their medical histories are similar. However, Jane’s symptoms are oddly different from Jill’s symptoms. While you are using a similar approach for both of them based on their diagnosis and medical history, Jill’s progress is much slower and more unpredictable. Jane’s symptoms clear up, she’s discharged and on her way. Jill doesn’t get the relief she was hoping for, loses faith, quits treatment, and leaves your clinic feeling defeated. We know that Jane and Jill present similarly in terms of their physical presentation. What is their range of motion? What does their imaging say? What muscles are weak? How do they move? Jill later revealed that she just lost her mom, her job was very demanding, and she didn’t feel like she could go to anybody for support. Her stress was high, her body felt tense, and she’s been so overwhelmed that she hasn’t been motivated to do her home exercises. Jill carries a lot of fear and anxiety around her pain. She’s developed hypervigilance and a habit of catastrophizing. Therefore, she moves very little and has “fear avoidance.” Jill’s experience of her world, her body, and her pain is vastly different from Jane’s. Jane has a great social support network with friends who are happy to help when her pain flares. She works from home, allowing for a flexible schedule if she needs rest. Jane has become more informed about how chronic pain works, so she doesn’t have as much fear when pain does limit her. She feels safe to ask questions during treatment and motivated to do her exercises. • Looking at this situation through a trauma-informed lens allows for greater understanding and compassion when somebody isn’t improving in our care. • Exercises: ○ Since you know Jill is carrying a lot of stress, you provide her with some gentle “vagus nerve” exercises. With these exercises, she feels empowered to manage her overwhelm that has been keeping her from being consistent with her therapy.
CASE STUDY 4: MARIA
Maria, a 45-year-old woman with chronic lower back pain, struggled for years despite physical therapy, medications, and surgery. Her history of childhood trauma, including neglect and emotional abuse, left her anxious and hypervigilant during medical visits, causing missed appointments and difficulty adhering to treatment plans. Dr. Smith, using polyvagal theory, recognized Maria’s sympathetic state and prioritized Maria’s sense of control and creating a safe, paced environment. Dr. Smith built trust, which reduced Maria’s anxiety, improved treatment adherence, and ultimately lessened her pain perception, helping her feel more in control of her health.
WORKS CITED https://qr2.mobi/trauma-care
Powered by FlippingBook