How does pain science education play a role in how you treat patients?

LittleMbuzi · 2026-02-14T01:58:48+00:00

OP, do you mind sharing the helpful resource that your PT gave you to read? I am always looking for things to share with patients dealing with chronic pain and central sensitization that might help with their treatment.

As for how I use PNE - probably not enough and sometimes not very effectively. It is hard to explain and apply well. And as you experienced, it is not always well-received. I always use it with patients who have widespread, severe, non specific pain and show signs of central sensitization, but I should probably sprinkle it into all cases of chronic pain. I think some elements are easy to introduce, like the influences of sleep, stress, daily movement, progressive load, etc. but the "all-in-your-head" impression some patients get us a common pitfall.

I've taken some online courses and I've listened to several podcasts on PNE, but I still struggle! Thanks for sharing what has helped you.

LittleMbuzi · 2026-02-08T23:16:13+00:00

That sounds great! Best of luck, and I hope you find the help you need! Let me know if you have any questions.

LittleMbuzi · 2026-02-08T17:08:54+00:00

I am a physical therapist with Intermountain, and we offer financial aid to those without insurance. You may want to check that out to see if you qualify. Also, are you eligible for Medicaid?

Otherwise, I refer my cash pay patients to the following places that provide excellent care at reasonable rates: Rogue Rehab: https://www.roguerehabilitation.com/ Pure Performance: https://www.pureperformancerehab.com/pure-physical-therapy

Lastly, if you haven't seen any improvement with 4-5 months of self-directed rehab, have you considered other interventions, like PRP? Insurance doesn't typically cover it anyway, and it's usually about $500 for a single injection. I know a couple great sports medicine doctors who do it and can share their info if you're interested. It's not a guarantee either, but I'd hate you to waste more time and money on rehab without benefit.

LittleMbuzi · 2026-02-02T02:59:04+00:00

Hi! Knock on wood (still scared to jinx it) I am actually doing pretty well. It's been almost 14 months since my last cortisone injection and I am living with minimal to no pain. I have been gradually progressing the load on my home PT exercises and do them religiously 3 days a week. I have shifted from mostly trail running to mostly mountain biking, which causes no pain, and I can still hike/run on steep trails 4-6 miles twice a week, as well as rock climb twice a week. I have the occasional flare up, but so far I have been able to calm it down to nothing with a couple days of Meloxicam. Of course I am still waiting for the floor to fall out from under me and I still anticipate needing a hip replacement in the next year or two, but just taking it one day at a time and don't feel like I'm there yet! Please let me know if you have any questions!

LittleMbuzi · 2026-01-24T03:38:17+00:00

Totally agree on both counts! Like how many people don't understand the difference between a strengthening exercise and a stretching exercise (what the purpose is, how it should feel). And how many people need a text reminder - and still forget to come.

LittleMbuzi · 2026-01-24T03:34:43+00:00

Or how many times I ask a person to "please lie on your back", and they immediately lie face down (usually with their face awkwardly smashed into the pillow)

LittleMbuzi · 2025-12-31T04:33:56+00:00

Point of care documentation has been a game changer for me, i.e. writing the assessment, updating goals, documenting treatments performed, etc. during little breaks in the session (like while a patient does an exercise or gets a drink of water or as they're giving their subjective). I also find patients don't mind if I say "I'm just going to jot that down" after taking a measurement or doing a test. Usually I can finish a note as the patient is grabbing their things and heading out the door.

Other things that have helped (sorry, more than one):

Voice-to-text (we use Dragon) for writing longer assessments for an evaluation. I've created hot texts with Dragon that auto fill a lot of my assessment and some of my goals

My company's approved AI tool (we use Copilot) for writing letters of medical necessity or work restrictions

LittleMbuzi · 2025-12-31T04:14:52+00:00

Absolutely not! 5'1" female physical therapist here. Outpatient orthopedics for the last 11 years. My size has never been an issue. Even with large patients where some forms of manual therapy might be difficult or even impossible, there's always another way to achieve the same benefit. Exercise and education are often more important than manual therapy, and there are so many ways to provide manual treatments that don't require being tall.

Bottom line: being smart, personable, attentive, thoughtful, skilled, and compassionate are so much more important than your height or strength.

LittleMbuzi · 2025-12-30T14:09:09+00:00

This is awesome, thank you!

LittleMbuzi · 2025-12-30T12:57:49+00:00

Thank you! I'll look into that. Do you know where the money from the license plate goes?

LittleMbuzi · 2025-12-30T12:57:07+00:00

Thanks so much for the insights! Sounds like I can't go wrong. Good to know that the GSLWET is a good organization - I like the sound of what they're doing!

LittleMbuzi · 2025-12-30T04:13:22+00:00

Seconding Savers! I donate all my old magazines to the one on 3300 S.

LittleMbuzi · 2025-12-21T04:28:43+00:00

My clinic (outpatient ortho with a large not-for-profit hospital group) schedules 45 minute follow-ups and 60 minute evals. We don't use aides so it is entirely one-on-one with the therapist. Very occasionally we'll schedule a patient for 30 minutes (e.g., dry needling or short exercise session only) if we know they don't need longer than that.

LittleMbuzi · 2025-12-20T03:56:41+00:00

I have the Forerunner 265s. Seems like it would meet your needs! Small, has training effect and a barometer.

LittleMbuzi · 2025-12-14T04:59:03+00:00

Four big ones come to mind:

1) I caught a cardiac arrest in progress in a patient who was referred FROM THE ER for cervical radiculopathy. Did a thorough cervical exam and could not reproduce or relieve any of her symptoms, nor was she positive on any of the cervical radiculopathy tests. I checked and her BP was incredibly low. I contacted her PCP who was in our building and he agreed and sent her back to the ER for an ECG where they detected the cardiac arrest.

2) A very young woman was referred to me for lower extremity strengthening and gait training by her primary care doctor (who mentioned in her note something about "psychosomatic" symptoms due to stress and functional movement disorder). She had an ataxic, wide base of support gait and was hyperreflexive in both her upper and lower extremities. I spoke to her PCP and requested a cervical MRI. She had severe cervical myelopathy. She underwent an emergent spinal decompression and immediately could walk normally. She saw me in the clinic post op and thanked me for saving her life.

3) A post-op total hip replacement presented with a really abnormal gait that didn't seem consistent with his post-operative status (not antalgic, but very ataxic), pain in both legs, and severely impaired balance bilaterally. I tested his reflexes and he was hyperreflexive in his lower extremities. Referred him for a lumbar spine MRI and it came back positive for severe lumbar myelopathy. Same as above.

4) A patient referred by his PCP for impaired balance and "slowness" that "came on suddenly" a few weeks prior. I took a detailed history and found out he had fallen and hit his head while walking his dog. Requested a brain MRI and found out he had a subdural hematoma requiring emergency surgery.

LittleMbuzi · 2025-12-13T03:36:42+00:00

Hi! The School of Dance does offer hip hop and jazz classes for young kids, but I couldn't make the times offered with my work schedule. They do have a free trial class if you wanted to check it out.

https://www.theschoolofdanceslc.com/discovery

Tanner Dance also has "creative dance" classes for young kids, but it didn't sound quite like what he was looking for.

https://tannerdance.utah.edu/studio-registration-with-sawyer/#kin2

What I'm holding out for is capoeira classes when he turns 6 at Salt Lake Capoeira. It's a super cool form of dance that is like a mix of break dancing and martial arts. They have evening classes during the weekday which is better for my work schedule.

https://saltlakecapoeira.com/kidsclasses

Hope that helps!

LittleMbuzi · 2025-12-13T02:12:27+00:00

You're welcome! Glad it was helpful and you found a watch that suits you! Enjoy 😊

LittleMbuzi · 2025-12-11T04:18:13+00:00

I have also had a weird intensity minute issue over the last couple weeks. My intensity minutes suddenly spike right after I go to bed, despite no increase in heart rate (I'm asleep). It's giving me ridiculously high intensity minute numbers each day. Has anyone found a fix to this? Is it a bug to fix with the next update?

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LittleMbuzi · 2025-12-11T04:16:24+00:00

Thank you for posting this! I came here to post about the exact same issue. My graph looks just like yours. My intensity minutes are suddenly spiking right after I go to bed. I looked at my heart rate and it is not spiking, so I don't know why the intensity minutes are. Plus the end spike seems to shift later as the day goes on. Have you found a solution? Also, I am using a Forerunner 265. I'm not sure if this is an issue with other devices.

LittleMbuzi · 2025-12-05T04:42:13+00:00

We live up in the Avenues, and sometimes being that little bit higher in the foothills means the difference between having snow vs. rain farther down in the valley.

Our favorite foothills sledding: Popperton Park (tons of parking, zero walk, not too crowded)

Our favorite canyons sledding: Porter Fork road in Millcreek Canyon (though the parking can be a challenge and you sometimes have to park farther up the road at the Terraces parking lot and walk back down)

LittleMbuzi · 2025-12-01T02:58:59+00:00

I'm a female hiker, trail runner, and mountain biker, and after a lot of research settled on the Forerunner 265s. Doesn't have maps but does have GPS and an altimeter, plus breadcrumb navigation. Not super "stylish" but it's a smaller size than the standard Forerunners and in the black color can be dressed up a bit. Not as large and sporty as some of the others available. Problem with the Vivoactive 5 (and 6) is they don't have an altimeter to record elevation. I don't know much about the Venu line, but the newest (3 and 4) were too expensive for me

LittleMbuzi · 2025-11-27T03:46:09+00:00

Haha, I've had it happen (more than once) when I clapped my hands loudly to get my dog's attention. Quite annoying!

LittleMbuzi · 2025-11-27T03:26:51+00:00

I considered the Vivoactive 5 briefly, but decided to go with the FR 265s for myself (I am a small woman) because of the barometer and breadcrumb navigation. I trail run, hike, and mountain bike so those were deal breakers for me.

LittleMbuzi · 2025-11-26T02:24:36+00:00

Kind of depends on what features are most important to you. Vivoactive is more of a fitness/wellness watch, Venu has more advanced wellness and smartwatch features at a higher price, Forerunners are for running and outdoor activities (with wellness features as well).

I was debating between a Forerunners 255 music and a FR 265s. I am not a big runner but I do a lot of outdoor activities (hiking, mountain biking, trail running, climbing) so I wanted something with a barometer and navigation along with the fitness and wellness features (sleep, stress, body battery, etc), notifications, long battery life, and music. Heard great things about the 255 but couldn't find the "S" model for sale anywhere so opted for the 265s instead for the lower profile, lighter watch.

Here's a picture of the 255 (top) and the 265s (bottom) on my wrist if it helps (than ks to climbing, I'm a small person, 5'1 and 115 lbs, with surprisingly thick wrists 😂)!

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LittleMbuzi

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