Case of the Month #33: Exploring Patient Stories, Language and Communication

Published: 31/10/2023

Case 2

A 43-year-old male was referred to the Pain Service by his GP with persistent low back pain. This began 6 years ago, and he desperately wanted to find a solution to his problem. He had seen two spinal surgeons in the past who both agreed there was no surgery indicated. He had seen several physiotherapists in the past and had an MRI scan, which confirmed minor disc degeneration with no nerve compression or other significant pathology. 

The patient underwent a comprehensive assessment by a doctor, specialist physiotherapist and clinical psychologist in the pain service. They explored his story of living with persistent pain, including evaluating his understanding and beliefs of his pain experience. His pain began gradually after a busy and stressful week in his role as a sales manager. His symptoms gradually increased over three to four of months and got worse when he was driving. Now, every time he sat in his car seat, his pain increased significantly, and he described excruciating pain across his lower back, extending up his spine to his neck. He described his understanding of his structures in his back, explaining that he thought he had “The spine of a 75-year-old” with “Crumbling discs” and “Bone on bone” in his back. 

  • How could you help this patient make sense of his persistent pain problem?