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La Psychologically Informed Practice nella gestione del paziente con cervicalgia aspecifica; stato dell’arte e indicazioni per i terapisti manuali

Psychologically Informed Practice in the management of patients with non-specific neck pain; state of the art and indications for manual therapists

Autori

Cinzia D’Orsi, Private Practitioner, Travedona, Varese,Italia.

Marta Palma, Private Practitioner, Milano, Italia.

Luca Falsiroli Maistrello, Department of Neuroscience – Physical Medicine and Rehabilitation, ULSS8, S. Bortolo Hospital. 36100 Vicenza, Italy

Introduction

Pain is a multidimensional perceptual phenomenon that spans multiple dimensions, involving physical, emotional, cognitive and psychological aspects. Pain can have a significant impact on social relationships and can cause disability with major limitations in activities of daily living.
It is essential to adopt a multidimensional and flexible clinical reasoning model that allows the clinician to identify the different psychosocial factors that may negatively impact the patient’s recovery.
Psychologically Informed Physical Therapy (PIPT) is an innovative approach that goes beyond the mere recognition and treatment of the physical cause but also expands to the assessment of factors that lead to disability resulting from activity avoidance. Although research to date has mainly focused on the application of PIPT in patients with Low Back Pain, it is possible to extend this approach to many other musculoskeletal conditions, including Neck Pain.

Methods

In this Perspective, through a literature review, the basic concepts of treatment strategies through the application of PIPT were summarised and integrated into a framework, which can guide the clinician in the management of the Neck Pain patient.

Results

The designed multidimensional clinical reasoning starts with an interview to identify relevant psychosocial factors, followed by the objective examination. In the last step, useful techniques are described to assist the physiotherapist in the clinical application of PIPT in the Neck Pain patient.

Discussion and Conclusion

The guidance provided should be considered as a general resource, characterised by a certain degree of flexibility to be adapted to individual differences, thus allowing the creation of customised treatments.

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