The following is a metaphor to help understand the benefits and burdens of active and passive treatment strategies.
Which is better : Active treatment or Passive treatment? (you likely already have an opinion here…) Active treatments are things the patient does. Passive treatments are things the patient has done to them. Let’s look at the pros and cons of each.
So, in the above picture is the Pain Company. You can either be subordinate to the pain company, or you can be the CEO and be in control. You can get in control of your pain through either hard work and working your way up the ladder (Active) or you can get a hand up, someone in a high up management role or a friend to vouch for your credentials, to accelerate you up to CEO (Passive). Both of these approaches have roles to play in both business and in controlling pain.
- Passive: What if you are a clerk in a huge company and someone suddenly promotes you to CEO of that company; how successfully managed would the company be? This can happen in physical therapy, often through manual treatments, modalities, etc. The DPT can get your pain under control for you. We are the hand up. Relying purely on this, however, does not leave the pain well managed.
- Active: What if you started out as a clerk in a huge company and kept your head down and worked very hard to get promoted to CEO; could you make it without a helping-hand here and there? This can happen in physical therapy as well through Home Exercise Program, lifestyle changes, adherence to healing guidelines, etc. The patient earns and learns the ins-and-outs of their condition and, if successful, makes for a well rounded manager of their pain. Relying purely on this is a long road and not suited for everyone’s mental fortitude.
There certainly are outliers on both sides of the Active-Passive model in both business and in physical therapy. Those that can make it strictly by hard work, or those that can make it just off the help of others. But in life and in controlling pain a mixed approach is often the most successful.
It is my opinion: the more active the better with all due respect for passive. Perhaps a 70/30 ratio Active/Passive. As you creep closer to 50/50 and ratios below this, the outcomes will likely be worse… but I’m willing to be wrong here.
Those that put in no effort are not likely to be successful in the longterm.
Those that keep their nose to the grindstone often miss opportunities for advancement via those willing to help.
How much active and passive treatment do you employ? Insights welcome…