Chronic pain patient

Wow these patients seem to be following me from prac to prac. This particular chronic pain patient is 2 years post MVA and had recieved a full year of passive PT (mobs and ST massage) and chiropractis treatment at the expense of the insurance company- this improved her pain and dizziness markedly. She then came to the hospital I was at and the previous student did a further 5/52 of passive Rx which also improved her pain.

I then came along- luckily on that day accompanied by my CCT who advised me to go completely hands off. At the end of the first Rx session where I gave her deep neck flexor exs, postural correction, mobility exs, stretching and heat application as well as education ++++ she turned to me and said so no physio today then? Clearly the message hadn't got through. I then explained that PT= exercises not just passive treatment. She was most unhappy with this and I thought she might DNA after that.

She didn't, she kept coming back which was great, but every Rx session reported incraeased pain (usually 10/10 or more) dizziness, nausea etc. Now I know that passive treatments are not the answer for these patients and I have done exercise programmes instead for heaps of patients but it gets so much harder when someone else has already given them the passive treatment, and even worse when it has worked.I think if I hadn't had my CCT pushing me to stick to my Rx choice I would have given in and at least tried both. I suppose both might work too with some patients but the student before had given the patient one HEP exs an UT stretch and she couldn't even remember that- she was just so fixated on the hands on treatment she couldnt even combine it with active exs and my CCT thought it was best to just leave passive treatment for a period of time.