What the Stock-market and Pain have in Common


Lower back pain is often self resolving.  As practitioners or patients, we hear that quite often.  However, what we don’t hear is the future of the pain.  The pain might be self resolving at the moment but what about when it comes back?  Self management has always been a key factor for allowing the patient to manage their pain.  Empowerment over the problem is essential for the patient to regain confidence in themselves.  Pain in itself has deep roots both in traditional medical thinking and more obscure metaphysical (Jedi power) type reasoning.  Either way, it is very real to the patient.  But telling the patient to not think or worry about the pain has little effect.  Below is a more systematic methodology.  This is a short write-up and I have not expanded on many of the aspects I personally use to predict and monitor pain (or trade my personal or clients portfolio) but its a start into the idea.

Buy/Sell or Treat/Prevent?

When we look at pain over a given time we start to see a pattern of troughs and peaks.  Peaks stimulate worry and concern and are often the reason for the patient to seek immediate care.  On the contrary, troughs are when the patient feels like improvement is happening or they are in control of their pain.  The question is how is this monitored?  The simple answer is outcome assessment (OA).  OA is so often overlooked; both in the medical realm but also in the personal training/health coach sectors.  Most practitioners administer their OA at the end of treatment which will usually yield a positive result. However, what about 1 week, 1 month, 6 months, 1 year later?  Is there a return or has it started fluctuating again?

When we look at market trends we see something very similar to pain (especially if your portfolio is bearish).  When I say similar, I mean in a trending sense.  We see peaks and we see troughs.  In the market we have fundamentally driven fluctuations and technical fluctuations.  Fundamentals are news releases, CPI’s, GDP’s, etc; while technicals are geometric patterns or indicators that may result in a group of people buying or selling.  However, there is inverse emotion when comparing pain to the stockmarket.  We see consumer excitement at highs (peaks) and consumer worry at lows (troughs).   While we can not predict where one may go to the exact cent, we do have an idea of the overall trend of a stock or currency.

Empowerment through Reflection

Pain when mapped out over long periods of time shows the client progress.  As humans we tend to be one way in our thinking.  We are able to focus on a vision and aim but we are hardly ever able to reflect and refine.   What I am saying is this.  Clients are able to establish goals and visions but often struggle to see improvement (especially in the short-term) unless properly monitored with outcome assessment. I suggest monitoring your clients in a simple manner.  Have them answer a series of simple questions on a slide or ruler scale (0-10).  Do this every time you see them (I even email my patients now and then to keep tabs).  Overtime trends appear and there is nothing more reassuring than visually seeing the progress.  Visual stimulation with reflection allows them to make the connection so necessary for mental positivity and empowerment.

A simple list for clients, 0 (lowest, i.e. no pain) to 10 (highest, i.e. major pain):

0-10: Pain
0-10:Motivation to Exercise
0-10:Sleep
0-10:Stress
0-10:Custom Category (Select a topic they may be having trouble with. i.e. smoking)

After acquiring this data, spend a short time asking about each.  If the client has selected a lower number than you would have expected don’t focus on why they didn’t choose a higher number, instead focus on why they didn’t choose a lower number.  For instance, if the client has selected a 4 for motivation, DO NOT ASK THEM WHY it wasn’t a 10.  Ask them what kept it from being a 1.  This will elicit their strong points.  Focus on these points for they hold the keys to change.

Pain doesn’t turn on or off.  It fluctuates and it fluctuates with predictability when monitored and analyzed properly.

We have to ask thee specific questions regarding the pain.

1.  What has happened in the past?
2.  What is happening now?
3.  What do we want to happen in the future?

Questions 1 and 2 are important for current history, treatment, and reflection; Question number 3 requires a different response.  For question number 3 you must ask yourself, “how?”  More importantly you need to know what “how” looks like.  Just talking about it here or there isn’t enough for the human mind.  We know it might feel better after a few treatments BUT what if it comes back?  If self-care and prevention techniques are in place, then the peak (or flare up) might not be as intense as the original pain.  If the patient doesn’t have a reference point, then patient perceives the pain as being pain.  The patient simply doesn’t think, “well this hurts but it’s not the pain I had 4 months ago.”  When the health care provider shows the patient their previous highs and they reflect, then the patient is put at ease regarding the severity.  Often when a patient begins to move properly, we see the start of a down trend regarding the pain.

There WILL BE flare ups.  This is guaranteed, we are not perfect, we are creatures of habit.  Changing and re-grooving movements and habits takes time.

However, with proper advice we are able to let the client know a flare will most likely happen and give them ideas on how to manage themselves when or if the flare up happens.  Letting the client know the flare ups will become less frequent and less intense and the good days will outweight the bad days will also put them at ease.  The key is to let them know, you don’t want pain to be a surprise.

In the middle of every difficulty lies opportunity. Albert Einstein

Don’t Panic!  Prevent!

In the stock-market, when stock begin to plummet, we see psychological disturbance.  This causes panic and worry.  This panic and worry has the potential to make things worse.  The same exact thing happens with humans in regards to pain.  Financial traders look at money management and stop-loss structures to reduce the risk.  In other words they cut their losses short or place stops that when triggered close their trade and preventing them from becoming worse.  As humans we need to adopt similar strategies.  Keeping the pain at bay through proper management is key.  Keeping your health portfolio in check is key to success during our time here on earth in regards to pain.  We will all die someday but let’s try to make is pleasurable and pain-free while we are in existence.  Just as successful investors has financial advisors, we as humans should have health advisors and coaches.  Seek people who want to be proactive and help you be prepared for tribulation when it arises.

Just like with stocks, movement and pain is about measuring risk and risk appetite.

In Summary, give the patient something to reflect on and you will be amazed at the response and feeling of relief (given you are doing the right things). That being said, we are also able to use such systems to monitor what is going wrong.  I believe that with detailed monitoring of pain, patients will be better off.  There is nothing more reassuring than knowing that improvement (even though not always rapid) is in fact, happening.  Remember that when things are turning south in regards to your pain, there is hope through empathetic management and reassurance.  Your company (body) is far from worthless.

www.anthonyclose.com
www.facebook.com/perfectspine

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About doctoranthony
As a spinal rehabilitation specialist with over 7 years clinical experience in the areas of - Spinal Manipulative Therapy, Active & Passive Spinal Rehabilitation, Functional Movement and Orthopedic Assessment, Strength and Conditioning Coaching, Fitness Programming, Business Development, Cognitive Behavioral Therapy, Motivational Interviewing and Consultancy - you can feel safe knowing that I understand the worry and concern surrounding spinal pain. This is why self-efficacy lies at the heart of my practice. For more info: nz.linkedin.com/in/anthonyclose

2 Responses to What the Stock-market and Pain have in Common

  1. Pingback: What the Stock-market and Pain have in Common (via Doctor Anthony’s Insight) « Fiftyone-43-four

  2. Pingback: Good Reads for the Week « Bret's Blog

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