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Complex Regional Pain Syndrome (CRPS) is one of the most challenging conditions physical therapists encounter—not because patients are non-compliant or difficult, but because the condition itself defies a purely biomechanical approach.
Recently, I found myself watching—and then rewatching—a short Instagram video by a professor that stopped me in my tracks. She opened with a simple but deeply provocative question: “One of the first questions I ask my students every semester is: Do you care if your beliefs are true?”
Addressing lifestyle as part of physical therapy may seem broad or even tangential in cases where a specific tissue loading mechanism is clearly responsible. However, there are several nuanced reasons why lifestyle interventions have a place in PT, even for patients who might initially seem to have a "reasonable lifestyle."
What is Dysautonomia?
There is much controversy in the physical therapy community surrounding which type of treatment(s) are the most beneficial. Those who believe exercise and motor control hold the key to understanding pain tend not to use manual therapy in their practice. I strongly believe that manual therapy has an important place in physical therapy treatment.
One of my clients came in recently with a flare of his IBS symptoms. This person reported pain in his hip as well as his lower back during his IBS flares. He also noted that the previous week had been very stressful at work. I mentioned that his stress level might be related to his increase in symptoms. And he asked me how. Here is a bit of my response.
Have you ever felt your heart pound, your head pound or your stomach growl? If so, you were feeling those sensations through a specialized branch of your autonomic nervous system called the interoceptive nervous system.
People often ask me about visceral mobilization/manipulation. They often ask questions like What the heck is that? Aren’t you a PT? Is it like Reiki? Are you going to rearrange my internal organs?