8 Key Points

The way we are taught to do an “initial examination” is neither practical nor effective.  Yes, it covers the important questions for diagnosing a patient’s problem, but it has its drawbacks. The nature of the questioning often leads to an interviewing process which is far too lengthy.

This causes a number of critical problems:

  1. Firstly, it leaves barely enough time to do the rest of the consultation, including an accurate assessment of the problem, explanation of the findings, treatment, advice and even exercise prescription.
  2. Secondly, it can cause the patient to become anxious about time and to begin to lose confidence in you as a therapist.
  3. Furthermore and most importantly, a traditional initial assessment neither facilitates nor allows time to cover the 8 key points.

These 8 key points are important to provide the best quality care for our patients and build long lasting patient rapport.


  1. Am I in the right place?
  2. Can you help me?
  3. What’s wrong?
  4. How long will it take to get better?
  5. How often do I need to come?
  6. What can I do if it doesn’t get better?
  7. What are YOU going to do to help me?
  8. What can I do for myself?

Here at Enhance Physiotherapy, part of putting you first is to answer YOUR questions, not interview you.  We have come up with a unique initial consultation that answers all your questions and helps you get the answers you need to know to know that you have made the right choice.  Here’s what we think…..

These 8 key points are the questions the patient has “buzzing around” in their mind when attending a consultation. It is vital to provide answers to these questions as they are essential for building patient rapport, confidence in you as a practitioner and customer satisfaction.

Chronic Pain

Chronic Pain


By definition, Chronic Pain is persistent pain that lasts longer than 12 weeks. Most people may be new to the notion of chronic pain because we have the common belief that pain goes away when tissues heal after an injury or illness, usually less than 12 weeks. However, this is not the case for 1 in 5 Australians and pain may not lessen even when the healing process is complete.

Chronic pain is complex and can be frustrating because it involves the nerves and nervous systems.  Chronic pain occurs because of changes to the nervous system, which keeps the nerves firing and signaling pain. However, there are likely to be other factors that can contribute to chronic pain, including; genetics, gender and previous episodes of acute pain.  Chronic pain can be intense and unrelenting, and lead to various degrees of disability if it is not well-managed.

Chronic pain refers to the amplification of pain by the central nervous system. Pain itself often modulates the way the central nervous system does, meaning a chronic pain patient can become more sensitive and get more pain with less provocation over time.

Chronic pain is a grey area in health care. Because tissues have healed, however, the alarm system and brain have changed in an effort to protect you, diagnoses based on tissue processes are no longer fit. Patients end up with multiple theories depending on which healthcare practitioner they see.

For people with chronic pain from Fibromyalgia sufferers to a whiplash victim, changes in the spinal cord and the brain may no longer receive accurate information about what is happening in the tissue. In this sensitized state, the brain is being fed information that no longer reflects the true health and abilities of the tissues at the end of the nerve. Brain responses such as movement, thoughts, or autonomic, endocrine and emotional responses, are now based on faulty information about the health of the tissues at the end of the nerve.

Due to the complexity of chronic pain, it is important to be under the care of a healthcare practitioner who thoroughly understands the chronic pain pathways. This ensures that your pain can be properly managed and you can have a better understanding of your body and pain.

At Enhance Physiotherapy we use the latest up-to-date research and treatment techniques to treat chronic pain and we understand the frustrations behind the pain. We are here to plan, treat and offer options for you to lead a life that has pain at a manageable level.

How a Remedial Massage Therapist (RMT) can contribute to general health and wellbeing.

What is remedial massage?

Remedial massage is a form of bodywork used to identify and repair damaged areas of the body and increase the body’s own healing processes.

A skilled RMT plans to identify the reason for the tension and pain, treating both the cause and the symptoms.

What’s involved in remedial massage?

A range of techniques involving deep compression of local nerve and hypersensitive areas in muscles.

This can aid the release of toxins, relieve muscle and joint tension, and help pain management by way of stimulating the release of endorphins.

Passive or facilitated stretching is applied and recommended in order to lengthen the soft tissue, therefore preventing further tension and pain.

What are the post remedial massage effects?

In the initial 24-48hrs after your  treatment Individuals many experience the “Healing Crisis” which includes the following symptoms:

  • Pain/Tenderness & Stiffness
  • Fatigue
  • Nausea
  • Headaches
  • Light Headedness
  • Insatiable Thirst
  • Increased Urination
  • Emotional Upsets

To reduce the severity of these after effects it is advised to do the following: 

  •  Drink at least 2 litres of water daily.
  • Avoid alcohol for at least 4-6 hours post treatment.
  • Refrain from vigorous activity for at least 24 hrs post treatment.
  • Elevate your feet above your heart. Relax and Meditate.

What are the health benefits of remedial massage?

  • Stimulate the blood supply
  • Releasing muscle tension and pain
  • Increase joint mobility
  • Aid the repair damaged tissues
  • Improves posture
  • Immune boosting and increasing circulation
  • Stress reduction and heightened alertness
  • Improves skin tone
  • Relief from chronic complaints

The overall aim of the RMT is to provide balance to the length, tone and tension of muscles and tendons, which restores the correct position of the bones, increases blood flow and helps heal injuries.

In conjunction with a team of Physiotherapists and Exercise Physiologist at Enhance Physiotherapy, a skilled RMT such as myself will formulate the most ideal treatment plan and provide the highest level of care to those in need.

Apart from being a RMT for the past 16yrs, here are 5 things you might not know about me:

  • Has a partner for 20yrs and two gorgeous girls, 5 and 7yrs old.
  • Favorite fitness activity is swimming and walking.
  • Avid reader and movie/doco buff, esp crime thrillers and suspense.
  • Enjoys giving others energy healing using the benefits Reiki and Chakra Balancing.
  • Loves to go out dancing as it’s grounding and good for the soul!!


RMT at Enhance Physiotherapy Mandurah – to book an appointment with Briella call our clinic on 9583 5165.