Guest blog: rethinking chronic pain

Guest blogger Georgie Oldfield, founder of SIRPA™, looks at the role of non-physical factors in our perception of chronic pain

Chronic pain image

Have you ever wondered why (or noticed that) many of your clients have persistent or recurring pain, which began while doing something they normally did without any problem, or maybe soon after? Or maybe they woke with pain, yet it persisted for months or even years? This is so common, yet are we really that fragile that we can cause ourselves damage while doing something as innocuous as bending, getting out of a car or turning over in bed?

Despite a lack of supporting evidence, musculoskeletal pain is usually blamed on physical causes, such as poor posture (for example, reduced lumbar curve or one shoulder higher than the other, and so on), muscle imbalance (for example, poor core stability or hypermobility) or structure (for example, spinal degeneration such as a prolapsed disc or facet joint disease).  In fact no correlation has been found between pain and posture, structure or biomechanics (Lederman, 2011).

There are in fact numerous studies to demonstrate that degeneration – for example in the spine (Kim et al, 2013), shoulders (Connor, 2003), hips (Silvis, 2011) and knees (Kaplan et al, 2005) – are just a normal part of ageing.  Although the development of diagnostic procedures such as MRI and ultrasound scans have been invaluable, often when ‘abnormalities’ are found, it is assumed these must be the cause of any symptoms present, even though often the symptoms don’t match the findings on the scans. In fact, the studies highlighted above, found that about 80% of people without pain also have these ‘abnormalities’.

It is now widely accepted that stress ‘affects’ pain, so addressing this will clearly help in the management of pain. In fact, when you ask clients to consider what was going on in their lives in the lead up to the onset of pain, many will relate this to a challenge they were facing in their life, rather than a physical event.  Interestingly, a couple of studies (Christensen et al, 2012; Feyer et al, 2000) looked at the physical, biomechanical and psychosocial aspects of individuals’ lives and the only factor involved in the triggering of new episodes of back pain were psychosocial factors.

Another study (Castro et al, 2001) used personality profiling to see if they could determine who might develop whiplash symptoms after a placebo car crash, despite the fact that the force induced could not possibly cause any biomechanical injury. They found that they could predict with 92% accuracy who would have symptoms a month after the ‘accident’ – based on their personality profile.

Not only have personality factors been found to be a determinant of whether symptoms might persist or become more severe, so have greater exposure to past traumatic events; early beliefs that pain may be permanent; and depressed mood (Young Casey et al, 2008).  Add to this the strong link between adverse childhood experiences and ill-health in later life (Felitti, 1998) – including chronic pain (Goldberg, 1999) – and you can see why our focus needs to shift from the belief that there is always a physical reason for an individual’s pain.

In fact when you consider Kim’s study (2013), the poor results from non-surgical treatment for non-specific back pain (Keller et al, 2007), plus the lack of evidence to support the use of spinal surgery (Nguyen, 2011), injections for back pain (Chou, 2015) and morphine for chronic pain (Berthelot, 2015), it is clear we need to change our approach to the treatment of chronic pain.

Chronic pain has actually been found to be caused by the activation of nerve pathways in the brain. This results in persistent activation of the fight or flight response (our reaction to danger), which can cause real physical symptoms in the body. Most people have experienced a version of this when their face turns red with embarrassment or they feel a ‘knot’ in their abdomen in a tense situation.  When this normal human response becomes very strong it can cause very real, severe pain or other symptoms that can be disabling. Treatment consists of education about how the fight or flight response works; changing behaviour that might unintentionally keep it ‘turned on’; and working through current, and sometimes past, challenges that trigger our danger signals. Once the signals are turned off, the pain usually improves and often resolves completely, resulting in life-changing results for individuals.

As a physiotherapist who came across this concept 10 years ago, the results I have observed with my clients has completely changed the way I treat chronic pain and other persistent symptoms. I love the fact that the approach is non-invasive and we can help individuals recover through education and by becoming self-empowered and taking responsibility for their own health.

For references: visit

About Georgie Oldfield

SIPRA Georgie Oldfield

Georgie Oldfield MCSP is a leading physiotherapist and chronic pain specialist, promoting a pioneering approach to resolving chronic pain through her SIRPA Recovery Programme.

Hear her speak at the 2017 SIRPA conference, Chronic Pain: The Role of Emotions, being held on 15 October 2017, at the Royal Society of Medicine, London.  To read about leading experts who will be presenting at the conference and to book, visit

NB: This article refers to persistent, chronic pain, as opposed to tissue-damaging conditions, such as cancer, fracture, infections and autoimmune diseases.

Guest blog – is your website working hard enough for you?

In this blog, WebHealer – a supplier of websites to members of therapy associations – shares its tips on using a therapist website to save time, and improve the quality of client service.

The paperless office

Slowly but surely we are seeing paper replaced by digital solutions in most people’s everyday lives. In advertising, for example, you’ll be aware that Yellow Pages is a lot slimmer than it used to be – everyone uses Google these days. Administrative procedures too are now much easier to perform digitally than via paper, but are you taking advantage of this as much as you could be?

At WebHealer our primary goal is to help our customers improve the performance of their therapy practices. Often we are advising on matters related to search engines or marketing, but another important area of opportunity is to incorporate your website into your business procedures. Look at repetitive manual tasks that might be carried out more efficiently using online resources. We recently received some very encouraging feedback from one of our customers, Amanda Weller, at who has been working on improving her admin procedures.

‘I send a link to a website page (hidden from the menu) with my intake form on it to every single new client for them to fill in. Easy, no paper – brilliant. I have another page set up as a ‘thank you’ page which is automatically activated when someone sends the form back to me.

‘I really feel happy referring potential clients to my website, as it’s an effective resource which enables them to find answers to questions they may have before making the decision to work with me. I also use it with existing clients when I want to refer them to certain resources, or remind them how to do a DIY technique, etc’ said Amanda Weller.

Resource pages

If you have a website already, you probably have an FAQ (Frequently Asked Questions) page, which can answer questions potential clients are wondering about. But, as Amanda suggests, consider pages to store information sheets which you may otherwise have printed or stored somewhere else. The convention on the web is that downloads should be in PDF format (as it is safer from viruses), so if you create something in Microsoft Word just remember to save it as an Adobe PDF.

Interactive / feedback forms

Another area with a lot of potential is online forms. These are now within the reach of anyone with a small website. If you have a WordPress website there will be plenty of standard plugins for this. WebHealer clients have an option called PHD Forms, which Amanda uses. You can also just Google ‘online form builder’ and find a number of options at different levels of price and complexity. The more sophisticated (and typically expensive) ones might store the data for you or they might just email the results of the form to you. 

Forms can be used in lots of ways such as:

  • Patient information or client information questionnaires
  • Feedback forms
  • Suggestion forms
  • Booking forms for courses or events

Automate for ease

Using online forms should not make things more complicated for you. Standardise your procedures and incorporate automated tools to make your life easier as well as providing a more consistent and therefore higher quality service to your clients. By making it easy for you to send forms and collate the answers, it becomes practical to do this as a standard procedure. You can now invite feedback from clients routinely and perhaps pick up ideas to improve the quality of your service or modify things that clients may find confusing.



For more tips and advice on how a website can improve the performance of your practice, see the WebHealer eBook “Using the Web to Attract More Clients”, which has just had a major revision. Download the full eBook, here.


Guest blog – using the web to attract more clients

In this blog, WebHealer – a supplier of websites to members of therapy associations – share their tips on using the web to attract more clients using their unique approach, AIDAN.










Understanding the weakest link

AIDAN is a method of achieving great results from a therapy website, developed and refined by WebHealer over the last 15 years. It is based on the classic sales and marketing system AIDA. Our five stage version has been tailored for the web and for therapy websites in particular. It is not a single quick fix solution as no such formula exists. In fact an important first level of understanding with any approach like this is that to achieve success you can’t be blinkered looking just in one area alone. For example, many customers understandably become very focused on Google position.

Whilst this is important, on closer inspection it may be that Google ranking or visitor numbers are not major weaknesses for them. Their website may be attracting a lot of visits but first impressions are off-putting and so focusing on a better first impression will do the most good. We all have limited time, and so an understanding of the linked stages which lead to enquirers is critical. It allows you to focus on the weak link that will produce the most benefit for you.

What is AIDAN?


It starts with gaining attention, but not just of anyone. You need to attract the right people to visit your website. Only then do you have a chance to communicate a relevant message to them. Google is an ideal channel to attract people interested in what you offer, but just as important now is social media as well as good old word of mouth.


As a therapist your website’s first impression must be of integrity, and this starts with the basics, like checking for typos and poor quality images. Resist the temptation to include that funny animated frog you found online! A membership logo of your professional association will make a better impression. You may be a dedicated professional who doesn’t take themselves too seriously, but you only get one chance at a first impression. You also need to be mobile friendly – you will not convey integrity if your website looks broken on a mobile phone.

Dwell time

A positive first impression gives you the chance to engage your visitor’s attention, and a good indicator of this is dwell time. It answers the question “do my visitors like what they are reading?” The reason we use the more technical term dwell time is that it can be measured in terms of the minutes and seconds a visitor spends on your website. More is better! Increase this time by writing engaging content, genuine testimonials or perhaps a blog.


Ultimately you hope your visitor will take some form of action. Pre-internet this meant picking up the phone and making an appointment but there are now many more ways you can connect with a potential client. Remember, they may not be quite ready to see you but you can still establish a relationship for the future. They may follow you on Twitter or sign up to a newsletter for example. Think about how you can increase these options to connect.


Unlike a printed flyer your website is always work in progress, and by regularly reviewing performance across the prior four steps of AIDAN, you can nurture and improve your internet presence. Another perspective on nurture is that you can nurture your relationships with clients and potential clients. If you have a good Twitter following or several email newsletter subscribers you can invest time in those communications.

How well are you doing?

At WebHealer we build AIDAN into our customer service training and processes and into our customer’s website functionality, but you can use AIDAN by yourself. If you are looking to improve your website, why not take stock of how well you think you are doing in each area, and use it as a basis for your plans?


This article is based on the WebHealer eBook “Using the Web to Attract More Clients”, which has just had a major revision.  If you would like to download the full eBook, visit

Guest blogger Lisa Barber’s tips on making your therapy business sound different

In this week’s blog post, Marketing Teacher and Business Mentor Lisa Barber at Roots and Wings, is helping you make your therapy business sound different. 








It seems like everybody is a therapist these days.”

No matter how confident, ambitious or experienced you are, when you start out as a therapist and take time to get to know ‘the competition’, it’s inevitable that you’re going to have this thought at some stage. Take a closer look, and it can feel like everyone is saying and selling the exact same things as you, can’t it? Self-doubt and insecurity quickly follow as you wonder How on earth am I going to stand out? Why would clients book with me when there are all these other therapists to choose from? Can you relate?

When you’re looking to grow a business and build your client base, knowing how to get your unique approach across is a challenge for anyone. We’ve all been there, and if you don’t want to sound like all the other therapists in town, learning how to set yourself apart becomes vital.

How to find the right words to describe your therapy business.

If you’re struggling to find a way to sound unique, think about which group of people you’re taking a stand for and how you can help them. Let’s look at an example, so imagine your ideal client is a busy mum and that you offer bodywork. Instead of reaching for your go-to words like ‘relaxing’, ‘rejuvenating’ or ‘therapeutic’, ask yourself what her idea of ‘relaxing’ looks like.

For starters, she’s probably craving some ‘me time’. Yes, she loves her children. But what she wouldn’t do for some time out from school runs and phonics, from pampers and CBeebies and from Lego and laundry. Make a list of all the daily stresses she’s looking to get massaged away. Maybe she’s exhausted by the incessant ‘Mummy! Mummy!’ cries. Perhaps she’s broken by the lack of sleep and the 5am starts. Maybe she’s tired of never having a moment alone.  And now you can start to put these realities for your client to good use.

Instead of a picture of a lady lying on a massage table with the caption Come In And Relax, you could replace it with a headline like The Ultimate Child-Free Zone. Instead of Let Go of Your Stress, how about 60 Minutes Of No One Saying “Mummy!” or Where Late For School Stress Melts Away.  Rather than Find Your True Authentic Self, let’s try Stepped on a Lego Brick? I’ll fix you.

Once you get clear about the frustrations and yearnings of your perfect clients, it’s far easier to talk about how you can help them in a way that’s relatable and approachable. You can use phrases that are relevant to their everyday lives. And relevance is the first rule in marketing. When your headline and words speak directly to someone’s situation, you will have their attention. You’ll stand out in a way that makes your ideal clients say, Thank goodness you exist! Now let me grab my diary. So just how soon can you fit me in?










About Lisa Barber

Lisa Barber is the creator of ‘How To Market Your Holistic

Which helps sales-phobic therapists to attract clients who’ll pay their prices. If you’re feeling in the dark about how to promote your business without being salesy, visit Lisa’s website for no-cost strategies that work.