After missing the follow up visit

After a few weeks patient comes back to your office.

Her symptoms are persistent and she even says that the stiffness is worse now than when she first saw you.

You are now considering that you need to explain to your patient that you need to revisit the idea of managing the pain using a holistic approach. She has lost some time and that had a cost for her. You can now start over, by taking her medical history, prescribing some pain medication and taking some time to educate your patient on how pain management works and how she should learn to self-manage in a way that after a point she will be independent and able to make the appropriate choices to have the best outcomes.