The Talkative Patient

During my stay in Kalgoorlie, I encountered many interesting characters but none more interesting than a patient (Mr Z) who presented to the outpatient clinic with a 6 week history of low back pain. Mr Z reported that he had initially injured his back whilst serving a ball in volleyball (combined Lx flexion and rotation). He had already been to see his chiropractor for 6 sessions with minimal changes to his pain and finally decided that he would give physiotherapy a try. Upon my first session with him I barely had time to ask him about his pain as he had already come to a specific self diagnosis of his injury which he had found on an internet site. Mr Z began to ramble on and on about why he thought this was what was causing his pain, and was very keen to learn more. I explained to him that it was very difficult to specifically diagnose the cause of low back pain without imaging but began to educate him on the different structures that may have been affected from his initial injury. Mr Z found this very interesting and had found that this education made him feel more secure in knowing what the possible sources of his pain may be. After two treatment sessions his pain had begun to improve but I had noticed that he began to become very analytical of his pain, noting the changes in his pain each day and constantly questioning the manual treatment I was giving him. As I continued to treat him for a few more sessions, I found it hard to keep him on track as it was difficult to cut him off without coming across as rude or disinterested. I have come across quite a few patients similar to this through out this year, I was wondering if any fellow students had used different styles of communication to overcome this?