Why Words Matter to PTs

When Treating Patients, Always Aim To Choose The Right Words

As a physical therapist, whether you realize it or not, your words matter a great deal. Every time you interact with a patient, from the initial evaluation to the discharge visit, you have an opportunity to communicate clearly and help the patient understand as much as possible about their condition and their progress. Doing so will make the patient feel like they’re playing an active role in their own rehabilitation and increase their chances for a successful outcome.

Sometimes It’s Not Easy…

But always choosing the right words can be difficult, especially when it comes to telling the patient their diagnosis. Many—if not most—conditions treated by physical therapists can be classified by more than one term. Some, like a herniated disc, have what seems like a plethora of associated or synonymous terms (eg, bulged disc, ruptured disc, slipped disc), and which one you decide to use may be influenced by various factors.

You Can Learn, Practice, and Communicate with Greater Skill

Research suggests, however, that the terms you select when you deliver a diagnosis and prescribe a treatment plan really do make a difference. For example, one study evaluated how various terms affected the perceptions of about 2,000 patients with rotator cuff disease. Patients were randomly assigned to one of four groups in which combinations of four terms were used to describe their diagnosis and treatment. The diagnostic terms were “bursitis” and “rotator cuff tear, and appropriate definitions were given for each, and the treatment terms were “guideline-based advice” and “treatment recommendation.” Guideline-based advice provided positive prognostic information and encouraged for patients to stay active and not to worry about their diagnosis, while treatment recommendation stressed that treatment was necessary for recovery. All patients were then asked to assess their need for surgery (the primary outcome) and several secondary outcomes.

Study Finds – Just One Medical Term Can Change a Patient’s Perceptions

Results showed that labeling rotator cuff disease as “bursitis” decreased patients’ perceived seriousness of their condition and need for surgery, imaging, or to see a specialist compared to “rotator cuff tear.” “Guideline-based advice” also decreased the perceived need for surgery, imaging, injections, a second opinion, the seriousness of the condition, and recovery expectations compared to “treatment recommendation.” These findings show that simply telling a patient that they have bursitis rather than a rotator cuff tear and offering them guideline-based advice rather than treatment recommendations can significantly alter how they feel about their condition and whether additional interventions are necessary.

Avoid These Words…

This is crucial for physical therapists, as it is always a primary goal of ours to help patients recover as quickly and safely as possible without getting caught undergoing tests and procedures that may be costly, risky, or unnecessary. If you struggle to find the right words when speaking with your patients, here are some terms to avoid in your interactions and a few alternatives:

  • Try to avoid words with catastrophic connotations like chronic, degenerative, and unstable, since these terms suggest that the pain is unavoidable and will persist
  • Use “herniated disc” instead of a “slipped disc,” which suggests that the disc has slipped away and won’t return to its original position
  • Avoid using the term “damage” whenever possible; for example, if nerve damage is the patient’s chief complaint, find the cause and use alternative terms like inflammation, irritation, or narrowing of space
  • “Never” is another term to avoid in most cases, as in telling a patient they will never do again; instead, design a treatment program that will help a patient achieve their goal activity, or help the patient modify their goal activity so that it can be performed safely
  • Use “sprain” or “strain” instead of “tear,” which may cause patients to avoid moving the injured body part for fear of tearing it more

Contact ACE to Learn More

Words matter at Applied Continuing Education (ACE), too, as we focus on the importance of speaking to patients clearly and carefully in our two physical therapy continuing education courses (“Weight Management for Rehab Patients” and “Shoulder Pain and Dysfunction”).

If you want to improve your communication skills and are interested in learning more about our courses, review the ACE website to see if the courses align with your needs and values. You can also contact ACE at 781-229-8011 or info@physicaltherapyceus.com, as Mike and Justin are both more than happy to discuss our courses and answer any questions you might have.