The following are some misconceptions about the role of physiotherapy in psychiatry.

• “We massage patients so that they can relax”.
• “By giving attention to a patient’s pain, it will increase his/her awareness of and fixation on pain”.

This is not the truth. Our role is to identify and treat musculo-skeletal disorders that can develop over time in patients with mood and anxiety disorders, which can cause chronic headache, neck- and backache. How do these musculo-skeletal disorders develop?

A poor posture is the main reason why patients eventually end up with chronic pain symptoms

• The above abnormal posture is known as the upper crossed syndrome.
• This patient will typically complain of frequent headaches, especially behind the eyes, occipital area and forehead. Cause: The upper neck muscles are tight and shortened, affecting the bio-mechanics of the neck. Movement patterns are altered and muscle imbalances follow.
• This patient will also typically complain of anterior shoulder pain and often referred pain in one or both upper limbs. The arms are rotated inwards and with arm movements the rotating muscles in the shoulder will be pinched between bones, causing microscopic bleeding and eventually calcification in the muscle tendons. Surgery is often the only option to relieve this pain.
• A poor posture can affect the whole body and there are more syndromes that can cause symptoms of pain.

How do we manage pain in the face of chronic depression? The goal is to assist the brain in rewiring itself out of bothconditions.  In order to manage pain, the specific mechanisms need to be clearly defined by the physiotherapist and understood by the patient. A skilled manipulative physiotherapist can play an important role in determining possible biomechanical causes of pain as well as treating these structures effectively.

A function of the physiotherapist is to address / prevent poor posture in patients by education and exercises. Patients are advised not to take over-the-counter pain medication as this may have no effect on the biomechanical abnormalities. Over-the-counter pain medication may increase the risk of dependency.

Correct breathing is also important in the management of pain and forms part of the exercise plan that is given to the patient.

Through knowledge as to why they have pain, patients can be re-assured that the pain is not a threat and that they can manage their own pain without medication.

Our vision is to improve a patient’s quality of life and to limit disability as far as possible. Management of the body and mind provides A BALANCED OUTCOME