This is a thread of how I explain common conditions and processes to patients, would love some feedback on mine, and how you guys explain the same things. Appreciate there are many caveats and these are very general.

Tendinopathy: At the moment the demand you are asking of your tendon, is exceeding its ability. Ie It is not able to cope with your current workload.

Often once this tendon becomes irritated which may be after a single effort or multiple combined efforts, it becomes very irritated/sensitive and then often any action using that tendon will provoke pain.

Management of tendinopathy: What we need to do is firstly calm down that tendon, which means initially reducing activities that provoke pain. This doesn’t necessarily mean stopping, but just reducing the total workload.

In the meantime starting some gradual exercises in the background will enable the tendon to get stronger and increase its capacity/ability to handle your workload. It may also really help with the pain. (Also discussion around other lifestyle/social factors).

Sciatica 2nd to Disc: Sciatica is an umbrella term that simply means your sciatic nerve is irritated. Many things can cause it. In your case it’s likely from a disc. These disc bulges are very common and most of the time won’t cause any pain.

However (something from history) has likely caused that nerve near the disc to become irritated and sensitive. The good news is that the vast majority of these episodes will calm down in around 6/12 weeks.

It is totally safe to keep moving and exercising where possible and consider some pain management from the GP/Pharmacist etc.

OA Flare-up: As we get older our joints do too. Now I know your HCP said you have arthritis in your (body part) based on your X-ray. However, these changes have likely been happening for years/even decades, but are only now causing some discomfort/pain.

The knee currently is irritated due to many different factors (relate to history), but the good news is it will likely settle down again.

Importantly the knee structures don’t have to look better/change in order for the pain to go away, and these changes don’t correlate to how much pain you have, but that doesn’t mean I cant be blooming sore.

Movement and load-bearing exercises are really good for this, within your comfortable tolerance.

Mechanical/NSLBP: Firstly nothing you have told me or from my exam makes me concerned or worried that anything serious going on. Your back is totally healthy and strong its just (very) sore right now

This is often caused by an overload, where you have just asked your back to do a little more than it’s currently able to do (plus many other factors inc sleep, anxiety, and worry can contribute. I use Lehmans Cup Analogy here).

The good news is, that it’s totally safe to exercise and move, which is what I want you to do within your pain tolerance. Have a chat with a GP or pharmacist if you would like to consider some further pain relief.

Manual therapy: As part of your treatment I would like to (insert manual therapy here), this will help with some pain relief. What I would like you to bear in mind is that the biggest changes in your pain come from what you can do for yourself, not what I do with my hands.

What MT does do is give you a window of opportunity to move, stretch, exercise, go about your ADLs, give you some headspace to not be thinking about that horrible pain the whole time.

Thanks for getting this far, would love to hear your thoughts.