There an obvious difference in response to injury…say between someone who hunts, fishes, works on cars and is generally active, versus a patient who was chiefly a couch potato.
It is often recommended that chronic pain patients need to maximize their post injury health by lifestyle changes with good nutrition and minimizing anxiety, and eliminate maladaptive habits such as smoking.
However, there is an entirely different area of concern, and that is, “how has this individual’s lifestyle changed as a result of injury, and how does s/he cope with significant alteration in ability to participate in daily activities?”
I seldom hear of a patient’s primary (injury) physician asking the patient about his second jobs, hobbies, social involvement and activity levels prior to injury. Yet, you gain a great body of knowledge if you ask the patient “if you had not been injured, tell me what you would have done this weekend.”
The usual response is a wide range of interests and pursuits that gave meaning to life. But when you ask the patient how time is now being spent, you find s/he will describe inordinately long days arising from a sleepless night, followed by mindless and non-interactive daily activities, the tracking medication and looking forward to meals.
More often than not, the patient will tell me how life, physical appearance and degree of satisfaction have changed. The patient does not know in what activities it is now safe to participate. There is a fear of re-injury and/or just simply potentiating the pain.
Assistance in mobilizing, achieving a quality of life, enabling full participation in rehabilitative efforts must begin with a complete understanding of how, and to what degree, things have changed.